Dr. Richard Berry on Opening a Membership Practice
Since 2022, a Mentor, Ohio, family physician has built a membership practice around access, time and continuity. Now Maple Health is expanding direct primary care to employers.
Maple Health Direct Primary Care in Mentor, Ohio, is growing. Two new doctors join the practice in April, which its founder, Dr. Richard Berry, said will give the clinic more than enough room to take on new patients.
Dr. Berry, a family physician, opened the clinic in 2022, after finishing his residency. Members pay $70 to $125 a month, and the clinic does not bill insurance for the services the membership covers. In return, they get what many primary care physicians say they rarely have to give: access, time and continuity. Now Maple Health is expanding direct primary care to employers, at $90 a month per adult employee.
For physicians weighing ownership, the practice shows what changes when a clinic is paid by the month instead of by the claim. "Direct primary care has the potential to restore much of what has been lost in traditional health care: time, continuity, communication and a stronger focus on prevention rather than simply reacting to illness," Dr. Berry said.
The Decision to Own
Dr. Berry came to medicine by an unusual route. By his account, he grew up in London and served six years in the British Royal Marines, including operational tours in Afghanistan and Iraq. He attended Leicester Medical School in England and completed his family medicine residency at MetroHealth in Cleveland. A 2023 DPC News report on the practice also described his Marine service and training.
The usual path out of residency looks a lot like training. The hours are set, the panel is assigned and the revenue cycle belongs to someone else. Ownership reverses all three. The physician sets the hours, chooses the panel size and takes on the ordinary work of a small business, from staffing and facilities to technology and clinical capacity.
For Dr. Berry, ownership lets the payment model match the care. Traditional medicine, he says, still rewards encounters, procedures and billing complexity. "Direct primary care flips that incentive," he said. "The practice is paid to keep a patient cared for over time, whether the work happens in the office, by phone, by message or through proactive follow-up."
The Uncoded Visit
For a physician used to 15-minute slots, the bigger change is what a visit becomes when nobody codes it. Maple Health's home page promises same-day and next-day appointments and "complete 24/7 access to your care team," in the clinic or by video, voice, text or email. It lists a low patient-to-physician ratio, no charge for most in-office procedures, discount lab testing, an on-site discount pharmacy and home visits for newborns.
Each feature moves work out of the claim and into the relationship. A question that would have become a billable follow-up becomes a text. A lab draw that would have meant a referral and a separate bill happens down the hall at a posted price. The physician still does the work. No one has to justify it to a payer afterward.
That is the point, Dr. Berry said. "The future of the industry should give primary care clinicians more freedom to focus on clinical outcomes and patient relationships, while giving patients clearer costs, easier access and greater involvement in their own health care." He applies the same test to technology. "AI should increase doctor-patient interaction, not replace doctors," he said.
A Team Built for Continuity
Maple Health's clinical team includes Dr. Berry, physician assistants and support staff in business operations, phlebotomy and reception. Patients choose their primary clinician. A membership with a physician assistant costs $70 a month for patients up to age 20, $80 for adults 21 to 65 and $90 for those over 65. Membership with Dr. Berry is $125 a month. An $80 enrollment fee per person, capped at $200 per family, is waived for active military, veterans, police, firefighters and EMS personnel.
Both options keep the same direct primary care structure. Physician assistants at Maple Health manage their own patient panels within a collaborative clinical team rather than functioning simply as a way to increase visit volume. For a physician planning a practice, that is a decision about continuity. Every patient has a named clinician who knows them.
Dr. Berry is candid about the model's limits. "Direct primary care will not replace every part of the health care system, but it can become an important foundation for a more efficient, affordable and sustainable model of care," he said. Members may still need insurance for hospitalizations, specialist care, advanced imaging, surgery and other services outside the practice.
Medicare's Monthly Turn
Physicians who stay in the insured system are closer to this model than they may think. Medicare, Dr. Berry notes, is moving somewhat in the same direction through Advanced Primary Care Management, which pays monthly for longitudinal care instead of requiring each service to be separately time-billed.
Since January 1, 2025, Medicare has paid for Advanced Primary Care Management services through three HCPCS codes. G0556 covers patients with one or fewer qualifying chronic conditions, G0557 covers two or more, and G0558 covers Qualified Medicare Beneficiaries with two or more. CMS says the codes are billed once per patient per calendar month and are not time-based. Behavioral health add-on codes followed in 2026.
The service elements CMS lists read like a membership practice's brochure: 24/7 access for urgent needs, continuity with a designated team member, an electronic care plan shared with the patient, follow-up within seven days of an emergency visit or discharge, and asynchronous messaging that lets patients send questions or recorded data.
APCM still runs through a Medicare claim. It pays roughly $16 to $117 a month in 2026, depending on the code, and a new patient's initiating visit is paid separately. A Maple Health membership runs $70 to $125 a month and includes primary care visits. APCM patients must consent, must be told that only one practitioner can bill APCM in a month, and generally owe the 20 percent Part B copayment. Still, both models pay a practice to be reachable between visits, not only during them.
Expanding Direct Primary Care to Employers
Dr. Berry sees employer-sponsored membership as a natural extension of the model he already runs. "The real innovation in direct primary care may be employer-funded primary care," he said. "Instead of employers buying increasingly expensive insurance and hoping employees can find a primary care physician, companies can purchase primary care directly."
Employers have reason to listen. In Business Group on Health's 2027 Employer Health Care Strategy Survey, published in August 2026, employers projected a median 9.2 percent rise in health care costs for 2027, or 8 percent after plan design changes, according to the group's announcement. Sixty percent said they are elevating prevention and primary care. In the previous year's survey, published in August 2025, 35 percent said they would provide primary care at on-site health centers, InsuranceNewsNet reported.
Maple Health's employer program applies the same flat fee to a workforce: $90 a month per adult employee, a $60 enrollment fee and no minimum company size. Companies with 60 or more enrolled workers also get a physician assistant on site one full day each month.
Dr. Berry sees the employer arrangement as one piece of a larger structure. "This potentially creates a three-part model: direct primary care for everyday health care, high-deductible insurance for major events and transparent cash pricing for everything in between," he said.
A federal change helps that pairing. Since January 1, 2026, a qualifying direct primary care arrangement no longer blocks a patient from contributing to a health savings account, as long as fees stay at or below $150 a month for one person or $300 for more than one, according to IRS Notice 2026-5. Patients can also pay those fees from the account.
Whether an employer saves money depends on its insurance plan, workforce and renewal pricing.
Lessons for Physicians
For a resident or employed physician considering the same move, Maple Health's public materials offer a few practical lessons. Access is the heart of the membership, so the team must answer messages around the clock. Posted prices for labs and medications are part of the offer, not an afterthought. A collaborative team in which each clinician keeps a panel can preserve continuity as a practice grows.
Maple Health has shown since 2022 that the membership model works for individual patients in Northeast Ohio. The question Dr. Berry is now pursuing is whether the same model can scale from individual memberships into employer-sponsored primary care.
About Dr. Richard Berry
Dr. Richard Berry, MD, is owner and chief executive officer of Maple Health Direct Primary Care in Mentor, Ohio.
Family medicine.
Reported, fact-checked and edited by The Script Pad's editorial staff. See How we use AI.
This article is for professional education and does not replace clinical judgment. Treatment decisions should be based on the individual patient and current guidelines.
