PMPM (per member per month)
PMPM pricing charges a flat fee per active patient per month regardless of how many visits, orders, or messages that patient generates — a pricing model borrowed from managed care that some telehealth infrastructure vendors and clinical-service partners use instead of per-visit or platform-plus-usage pricing.
- Flat fee per active patient per month
- Borrowed from managed-care contracting
- Best for high-touch programs
- Definition of “active” decides the economics
When PMPM is the cheapest model
High-touch programs with many encounters per patient — frequent check-ins, messaging, labs, dose changes — get the most from a flat per-patient price, because usage-based pricing would meter every touch. Refill-heavy programs with one short check-in a month tend to pay more under PMPM than under per-visit pricing.
What to check in a PMPM contract
The definition of “active” or “member” is the whole contract. If a churned-but-not-cancelled patient counts, you pay for patients who are not being treated. Also check what falls outside the flat fee — controlled-substance visits, labs, and additional states are common exclusions — and whether there is a minimum member count.
- How “active member” is defined and measured
- What is excluded from the flat fee
- Minimum member counts and ramp periods
- How the fee changes across volume tiers
Compliance handled, so you can build
Lithos runs the clinicians, pharmacies, and 50-state rules behind your care program — one API.
Frequently asked questions
Is PMPM or per-visit pricing better for a GLP-1 program?
It depends on touches per patient. A program with one async check-in a month often pays less per-visit; a program with frequent messaging, labs, and adjustments often pays less PMPM. Model both at your expected volume.
What does “per member” include?
Whatever the contract says. Typically clinical visits and messaging; frequently excluded are labs, controlled-substance encounters, identity verification, and state expansion. Get the rate card.
Is PMPM the same as a subscription?
From the patient’s side a subscription is what they pay the brand. PMPM is what the brand pays the infrastructure vendor per patient. The two are independent decisions.