Emerging consumer/market based healthcare in the US?

For the record, I think the Affordable Care Act (ACA), aka 'Obamacare' is a disaster and things will get worse before before it gets better but there are still a number of interesting experiments emerging.

While VentureBeat credits the ACA for "li[ghting] a fire under the movement to rethink they way we deliver and pay for healthcare," the examples they cite seem to show that this is despite - not because of the Act.

Cato recently highlighted the Direct Primary Care model:

“Direct primary care” is a rapidly growing alternative to the traditional “fee-for-service” model of paying for medical care. Instead of the patient or his insurance plan paying the doctor separately for each visit or service, the patient pays the physician a set monthly fee. In exchange, the physician is available to consult with and treat the patient as necessary.

For patients, the benefits of direct primary care are greater access to their doctors and more convenient and personalized care. Under direct primary care, patients can generally expect “all primary care services covered, including care management and care coordination…seven-day-a-week, around the clock access to doctors, same-day appointments, office visits of at least 30 minutes, basic tests at no additional charge, and phone and email access to the physician.” Some practices may offer additional services under the arrangement, such as EKGs or medications at wholesale cost.

In fact, studies are showing that a number of doctors abandoning the onerous demands of filing to get insurance claims in favor of cash (Forbes). Interestingly, the very first company that VentureBeat cites - Evolent Health, supports doctors who move towards a direct pay/subscription model. Healthgrades, another company cited, rates and ranks hospitals - further empowering consumers. The others - Doximity, a Linked-In for Doctors, MindForce, a CRM for health and wellness firms, and Best Doctors, a service providing expert opinions for the employees of compaanies, all operate outside the ACA. If the business models of Evolent and Healthgrades thrive, this could be the positive legacy of the Affordable Care Act.