How Virtual Primary Care Saved $117 PMPM for 400,000+ Health Share Patients
A 12-month matched-cohort economic evaluation of 10,074 lives across Christian Healthcare Ministries — the largest health share in the United States. Peer-reviewed methodology. Population-level results.
Health shares face the same cost pressures as traditional payers
Christian Healthcare Ministries serves over 400,000 members across all 50 states, making it the largest health care sharing ministry in the United States. Like traditional payers, CHM faces rising medical costs driven by avoidable hospitalizations, fragmented care, and members who delay seeking help until conditions become acute.
But health shares operate differently. Members share each other's medical bills voluntarily, which means every unnecessary hospitalization and every preventable ER visit directly impacts the community. CHM needed a solution that could provide accessible, longitudinal primary care to a geographically dispersed, national membership — without requiring members to navigate traditional insurance networks.
In late 2024, CHM partnered with HealthTap to deploy virtual primary care at scale, giving every member access to a dedicated physician relationship through HealthTap's platform.
Longitudinal virtual primary care — not episodic telehealth
HealthTap's model is fundamentally different from on-demand telehealth. Instead of one-off urgent care visits with rotating providers, patients are matched with a dedicated primary care physician who manages their health over time — building the kind of doctor-patient relationship that drives better outcomes.
Dedicated PCP
Each patient is matched with a personal physician — not a rotating pool of providers.
Longitudinal Care
Ongoing management of chronic conditions, preventive screenings, and care coordination.
Nationwide Coverage
Available across all 50 states — reaching patients wherever they live, regardless of geography.
Rigorous methodology, real-world data
To measure impact, we conducted a 12-month retrospective matched-cohort economic evaluation comparing 5,037 HealthTap patients against 5,037 propensity-matched controls, matched exactly on sex and nearest-neighbor on age and cumulative 24-month claims history. Post-matching balance was excellent: mean age difference of −0.009 years (SMD < 0.01) and no statistically significant cost differences in either baseline year (P = .20 and P = .68).
The study follows CHEERS 2022 and STROBE reporting standards. Of 5,264 eligible VPC patients, 95.7% were successfully matched. All findings were validated through sensitivity analyses including top-1% and top-5% outlier exclusion and 1:5 matching ratios — producing results that meet the evidentiary standards expected by actuaries, underwriters, and peer reviewers.
(5,037 per arm)
(12 months, 2025)
(age, sex, 24-mo claims)
The data tells a clear story
Across every metric — costs, hospitalizations, visit frequency, and demographic subgroups — HealthTap patients consistently outperformed the matched comparison group.
Costs diverged dramatically between HealthTap patients and the comparison group
Starting from matched baselines — where both groups had statistically indistinguishable costs in 2023 and 2024 — the two cohorts followed starkly different trajectories. HealthTap patients had 27.5% lower total cost of care in 2025 ($3,710 vs. $5,114 per member annually; P < .001), representing $7.1 million in avoided costs across the cohort in a single year.
Notably, HealthTap patients were on a steeper cost trajectory before the intervention (+30.1% from 2023 to 2024), making the subsequent deceleration more — not less — attributable to virtual primary care.
The comparison group experienced an 8.3× greater cost increase than HealthTap patients — a divergence that widened with each passing quarter. Hospital inpatient costs alone accounted for two-thirds of the total savings ($1,012 vs. $1,945 per member; −48%).
Figure 1. Matched cohort cost trajectories. HealthTap patients (blue) maintained near-flat costs while the comparison group (gray) experienced a 30.4% increase over 12 months.
Source: CHM claims data, 2025 follow-up period. Propensity-matched cohorts (n ≈ 5,000 per arm). Baseline: 2023–2024.
More visits = bigger savings
The relationship between number of visits and cost reduction follows a clear, monotonic dose-response curve. Patients with a single visit saw billed costs rise 26.5% (n = 368). Two visits: costs fell 7.6% (n = 177). Three to five visits: costs fell 27.9% (n = 186). And patients with 6+ visits — building a true longitudinal relationship — saw billed costs drop 47.6% (n = 53).
This finding is critical for benefits leaders: the value of virtual primary care compounds with each additional visit. Programs designed to encourage ongoing engagement will see the greatest return — and the curve is monotonic, meaning there is no point of diminishing returns within the observed range.
Figure 2. Dose-response curve showing payout reduction by number of visits. Patients with 6+ visits achieved 34.9% lower payouts compared to the matched comparison group.
Source: CHM claims and HealthTap utilization data, 2025.
Hospitalizations dropped by nearly half
Hospital admissions are the single largest cost driver in any health plan. HealthTap patients experienced a 47.5% reduction in hospitalization rates (7.8% vs. 11.9%; OR 0.63; 95% CI 0.55–0.72; P < .001) — a finding that held across age groups and baseline health status.
HealthTap patients also had 20.6% fewer ED visits (8.1% vs. 9.9%; OR 0.80; 95% CI 0.70–0.92; P = .001) and 20.5% lower overall claims incidence(26.7% vs. 33.6%; OR 0.72; 95% CI 0.66–0.78; P < .001).
Translated for benefits leaders: for every 100 patients enrolled in virtual primary care, approximately 4 hospitalizations are prevented and $140,400 in claims costs are avoided annually.
Figure 3. Matched cohort hospitalization rates. HealthTap patients had 47.5% fewer hospital admissions than the propensity-matched comparison group.
Source: CHM claims data, 2025. Propensity-matched cohorts.
Primary care patients held costs flat — urgent-care-only patients did not
Not all virtual care is created equal. When we segmented the broader 10,501-patient population by visit pattern, a striking difference emerged. Patients who used HealthTap for primary care (n = 2,425) maintained essentially flat costs (−0.5%) and had lower hospitalization rates (15.6%) and ED visit rates (13.0%).
Patients who used the platform only for urgent care (n = 5,874) saw their costs rise by 30.4%, with hospitalization rates of 18.3% and ED visit rates of 16.3% — nearly identical to the comparison group. This confirms that the value comes from the longitudinal relationship, not from telehealth access alone.
primary care patients (n=2,425)
urgent-care-only patients (n=5,874)
Figure 4. Persona-level cost trajectories. Primary care patients (blue) maintained flat costs while urgent-care-only patients (tan) experienced cost increases comparable to the comparison group.
Source: CHM claims and HealthTap visit-type data, 2025.
Results improved every quarter
The cost advantage of HealthTap patients didn't appear overnight — it compounded over time. Quarter by quarter, the gap between HealthTap patients and the comparison group widened, with the most significant divergence occurring in Q3 and Q4 of 2025.
This trajectory suggests that a longer deployment period would yield even greater savings — an important consideration for organizations evaluating multi-year contracts.
Figure 5. Quarterly claims cost trends. The cost advantage for HealthTap patients widened progressively from Q1 through Q4 2025, suggesting compounding returns with each additional quarter.
Source: CHM quarterly claims data, 2025.
Figure 6. Age-stratified analysis. Cost reductions were observed across all age groups, with particularly strong results in the 45–64 cohort — the demographic with the highest baseline costs.
Source: CHM claims data stratified by age band, 2025.
Implications for payers, employers, and benefits leaders
Proven ROI at Scale
10,074 lives analyzed with propensity-matched methodology (SMD < 0.01). 95.7% match rate. Validated through multiple sensitivity analyses. These aren't pilot results.
Savings That Compound
The dose-response curve is monotonic: 1 visit (−26.5% billed) → 2 visits (−7.6%) → 3–5 visits (−27.9%) → 6+ visits (−47.6%). No point of diminishing returns.
Hospital Avoidance
47.5% fewer hospitalizations (OR 0.63; P < .001). 20.6% fewer ED visits. Hospital inpatient costs alone fell 48% — accounting for two-thirds of total savings.
Works Across Demographics
Mean age 47 years, 66.7% female. The highest-cost quartile (mean $65K baseline) saw a 55.9% cost reduction — proving the model works where it matters most.
Primary Care, Not Just Telehealth
PC-only patients: −0.5% costs, 15.6% hospitalization rate. UC-only patients: +30.4% costs, 18.3% hospitalization rate. The relationship — not the channel — drives value.
Applicable Beyond Health Shares
While validated with CHM, the underlying mechanism — longitudinal virtual PCP relationships — applies to any population: self-insured employers, Medicare Advantage, Medicaid managed care.
What could this mean for your population?
Based on the CHM outcomes ($1,404 per member annually), a 50,000-member plan could project annual savings of approximately $70M in reduced claims costs — driven by 48% lower inpatient costs, 20.6% fewer ED visits, and 20.5% lower overall claims incidence.
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About This Study
This case study summarizes findings from "Longitudinal Virtual Primary Care and Total Cost of Care: A Matched-Cohort Economic Evaluation within a Health-Sharing Ministry" — a 12-month retrospective matched-cohort economic evaluation following CHEERS 2022 and STROBE reporting guidelines.
The study compared 5,037 HealthTap patients (first VPC visit in Q1 2025) against 5,037 propensity-matched controls over a 12-month follow-up period (2025), with a 24-month baseline matching period (2023–2024). Matching was exact on sex and nearest-neighbor on age and cumulative claims. Post-matching SMD < 0.01 for age; P = .20 and P = .68 for 2023 and 2024 costs respectively. All cost and utilization figures are derived from CHM's claims and sharing data.
Sensitivity analyses (top-1% and top-5% outlier exclusion, 1:5 matching) confirmed robustness of all primary findings. For a copy of the complete research paper, contact [email protected].