Healthcare is expensive. For many hourly workers and small business owners, it’s often out of reach. But it doesn’t have to be this way. A no-cost healthcare model isn’t a fantasy—it’s already happening.
Let’s break down what it takes to build a healthcare system that puts people first without raising costs.
Why the Current System Fails Most Workers
Most employee health plans are built for full-time workers at big companies. That leaves millions of people behind.
In the U.S., over 27 million people were uninsured in 2022, according to the U.S. Census Bureau. Many of them work part-time, freelance, or in low-wage jobs. Even those with coverage often face high deductibles and out-of-pocket costs.
Employers struggle too. Small businesses often can’t afford to offer benefits. Premiums have doubled in the past 10 years, making even basic coverage a financial burden.
The result? A system where many avoid care because they can’t afford it, leading to worse outcomes and higher emergency costs later.
The Key Principles of a No-Cost Model
To build a no-cost model that actually works, you need to change the rules. Here’s how:
Table of Contents
1. Rethink Who Pays
Instead of billing employers or employees, look at the existing streams of healthcare spending—especially pharmacy rebates, vendor markups, and administrative fees. These hidden costs are usually absorbed by the system.
A no-cost model redirects that money into care. “There’s already enough money in the system,” said one benefits innovator. “It just isn’t being used well.”
2. Use Value-Based Contracting
In traditional models, healthcare providers get paid per visit or procedure. That creates incentives for more services, not better outcomes.
A value-based approach flips that. Providers are paid based on how well they keep people healthy.
This saves money over time by preventing expensive treatments. It also leads to better care, fewer hospital stays, and happier workers.
3. Limit Middlemen
Most plans involve third-party administrators, brokers, pharmacy benefit managers (PBMs), and insurers. Each adds cost and complexity.
A no-cost model cuts out many of these layers. That means more transparency and fewer fees.
4. Focus on Primary and Preventive Care
Routine care keeps people out of the hospital. No-cost models often prioritise:
- Primary care visits
- Mental health support
- Prescriptions for common conditions
- Telemedicine access
These services handle most health needs without sending people to expensive specialists.
Lessons from HealthWorX
One of the most talked-about examples of a no-cost healthcare system is HealthWorX.
Built by benefits strategist John Theodore Zabasky, HealthWorX was designed to serve hourly and underserved workers. Many of these workers don’t qualify for traditional insurance or can’t afford premiums.
The model gives them access to key services with no out-of-pocket cost. Employers don’t pay extra, either.
Instead, HealthWorX uses pharmacy rebates and optimised vendor pricing to fund care. They also control claim costs by focusing on prevention and managing risk directly.
“Most people thought we were crazy at first,” Zabasky once shared. “But we proved you could offer primary care, prescriptions, and even mental health—at zero cost to the employee—and still keep the model sustainable.”
Why This Works for Employers
A no-cost healthcare model isn’t just good for workers. It helps employers too.
- Lower turnover: Employees with access to care are more likely to stay.
- Higher productivity: Healthy workers take fewer sick days.
- Cost control: With no premiums or claim spikes, businesses can plan better.
One small restaurant chain that adopted this model saw their turnover rate drop by 30% in one year. Another employer saved six figures on their annual benefits budget by switching from a legacy insurer.
How to Get Started with No-Cost Benefits
Step 1: Audit Your Current Costs
Look at your current health plan. What are you paying in premiums, admin fees, and claims?
You might be surprised by how much money is being lost to middlemen and markups.
Step 2: Partner with Transparent Providers
Avoid carriers and PBMs that won’t disclose pricing. Work with providers who show you exactly where the money goes.
There are benefits companies now that build entire plans on cost-plus pricing.
Step 3: Prioritise Core Services
Start small. Focus on the services people use most:
- Preventive screenings
- Prescription access
- Therapy or mental health visits
- Routine check-ups
If your team doesn’t need hospitalisation coverage right away, don’t overpay for it.
Step 4: Educate Your Workforce
If you offer no-cost care, explain how it works. Make it easy to access.
Use plain language. Keep onboarding simple. Let people know what they’re saving and how to use the services.
Real Challenges to Consider
No system is perfect. A no-cost model still faces some obstacles:
- Specialty care coverage: Not all services can be free. High-cost treatments may still require insurance backing.
- Regulations: In some states or countries, licensing rules make new models harder to launch.
- Change resistance: HR teams and brokers may push back if they’re tied to old systems.
But none of these are deal-breakers. With the right strategy and partners, it’s possible to shift your benefits model without blowing up your business.
The Future of Healthcare Is Built on Access
A no-cost healthcare model isn’t about giving something away for free. It’s about using existing resources smarter.
If you can offer care that’s easy to use, affordable, and preventative—you win.
Your employees stay healthier. Your business stays stable. And you build a workplace that people want to be part of.