How to Start a Telehealth General Psychiatry Practice in Pennsylvania

You became a psychiatrist to help people, not to become a marketing expert or wrestle with 50-state licensing labyrinths. But here’s the reality: if patients can’t find you, you can’t treat them. And if you’re not licensed where they live, you can’t legally see them via telehealth.

This guide cuts through the noise. We’ll walk through how to actually acquire patients without burning cash on marketing channels that don’t convert, multi-state licensing strategies that won’t drain six months of your life, and the cash-pay vs insurance decision that shapes everything from your daily schedule to your annual income. Whether you’re launching a solo telepsychiatry practice or expanding an existing one across state lines, these are the operational realities no one mentions in residency.

The Patient Acquisition Reality: What Actually Costs What

Let’s address the elephant in the room: acquiring psychiatric patients is expensive and time-consuming when you do it yourself.

The DIY Marketing Trap

Many providers hear ‘just do SEO and Google Ads’ and assume they can acquire patients for $30-50 each. That’s fantasy. Here’s what really happens:

SEO takes 6-12 months of consistent investment before you see meaningful patient flow. You’ll need to:

• Pay a consultant or agency ($1,500-3,000/month minimum for quality work)
• Create content regularly (your time or a writer’s time)
• Build backlinks and optimize technical elements
• Wait while Google decides whether to trust your new site

Even then, you’re competing with Psychology Today, Zocdoc, and every established practice in your area for the same keywords.

Google Ads for mental health are brutally expensive. Keywords like ‘psychiatrist near me’ or ‘ADHD treatment’ run $15-40+ per click. Most clicks don’t convert to booked patients. Between:

• Ad spend testing and optimization
• Landing page development
• Staff time to qualify and schedule leads
• No-show rates from cold leads
• Failed campaigns before you find what works

…your real cost per booked patient through PPC is typically $200-400+, and that’s if you know what you’re doing. First-time advertisers often burn $3,000-5,000 before seeing a single patient.

Directory listings like Psychology Today ($30/month) or Zocdoc (pay-per-booking model, ~$100-200 per new patient) are more predictable, but you’re competing with hundreds of other providers on the same page. Psychology Today can work well in urban markets—some providers report 5-15 inquiries monthly—but conversion to actual appointments varies wildly based on your profile quality and availability.

The Smart Economic Alternative

This is where a pay-per-appointment platform fundamentally changes the economics. Instead of:

• $3,000-5,000/month on marketing with uncertain results
• Months of waiting for SEO to generate leads
• Wasted ad spend on clicks that don’t convert
• Paying for directories that may or may not send patients

…you pay only when a qualified patient actually books with you. That’s guaranteed ROI vs gambling on marketing channels.

Here’s what that typically includes:

• Pre-qualified patients already matched to your specialty and availability
• No upfront marketing spend or monthly subscription fees
• No wasted budget on clicks, impressions, or leads that don’t convert
• Built-in telehealth infrastructure (no separate platform costs)
• Both insurance and cash-pay patient flow, depending on your preference
• You control your schedule—only pay when you see patients

Real Numbers Example

Let’s say a new patient generates $250 for an intake plus $150 × 4 follow-ups over the next few months = $850 total revenue per patient.

DIY Marketing approach:

• Monthly ad spend: $2,500
• SEO/agency fees: $2,000
• Staff time handling leads: $500
• Total monthly cost: $5,000
• If this yields 10 booked patients: $500 per patient acquired
• First 3-6 months often yield far fewer patients while building momentum
• No guarantee any of this works

Pay-per-appointment platform:

• Pay a standard listing fee per new patient (let’s say $150)
• Patient books, shows up, becomes part of your practice
• $150 cost per patient acquired
• Immediate patient flow from day one
• Zero risk if volume is low

The math is obvious. Even if the per-patient fee seems high, you’re removing all the uncertainty and wasted spend. And unlike paid ads, these patients are typically higher quality—they’ve already decided they want psychiatric care and have been matched to your availability and specialty.

The bottom line: For most providers, especially those starting out or scaling, a platform that handles patient acquisition removes the risk entirely. You can always layer in your own marketing once you’re at capacity and have cash flow to experiment with.

Free consultations available with select providers only.

Grow your practice on Klarity

Free to list. Pay only for new patient bookings. Most providers see their first patient within 24 hours.

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Free to list. Pay only for new patient bookings. Most providers see their first patient within 24 hours.

Multi-State Licensing: Your Roadmap Through the Maze

If you want to practice telepsychiatry across state lines, you need to be licensed in every state where your patients are located. Period. No exceptions, no shortcuts. Here’s how to navigate this without losing your mind.

The Interstate Medical Licensure Compact (IMLC): Your Best Friend

The IMLC is an expedited pathway for physicians to obtain licenses in member states. As of 2025, over 40 states participate, including Texas, Florida, Illinois, and Pennsylvania.

How it works:

1. Designate your State of Principal License (where you’re currently licensed)
2. Submit one application through the IMLC commission
3. Pay the commission fee plus each target state’s license fee
4. Background checks are coordinated centrally
5. Receive licenses in weeks instead of months

Critical exclusions: California and New York are NOT in the IMLC. You’ll need to go through their full standard processes, which can take 4-6+ months for California and 3-4 months for New York.

State-Specific Requirements Cheat Sheet

California:

• Timeline: 4-6+ months (known for backlogs)
• No expedited processing available
• Requires completion of pain management/opioid care training
• Renewal every 2 years with 50 CME credits
• Strong telehealth parity laws but no shortcuts for out-of-state providers

Texas:

• IMLC member—can get licensed in weeks via compact
• Must pass Texas jurisprudence exam (online, straightforward)
• Renewal every 2 years
• Excellent for telepsychiatry—allows initial video evaluations without in-person requirement
• NP note: Texas requires collaborative practice agreements for PMHNPs

Florida:

• Two options: Full license via IMLC OR Out-of-State Telehealth Registration
• Telehealth Registration is the game-changer: free, fast (weeks), no office required
• Allows you to provide telehealth to Florida patients without full licensure
• Catch: Can’t prescribe controlled substances via telehealth except for psychiatric disorders (you’re covered)
• NP note: Florida excludes PMHNPs from autonomous practice—they need physician supervision

New York:

• Not in IMLC—full standard process (3-4 months)
• Requires infection control and child abuse identification courses
• Separate controlled substance registration needed
• Strong telehealth support including audio-only for mental health
• NP note: After 3,600 hours, PMHNPs can practice independently

Pennsylvania:

• Joined IMLC in 2025—now expedited pathway available
• Requires 3 hours CME in child abuse recognition + 2 hours pain/opioid management
• Renewal every 2 years
• NP note: Pennsylvania is reduced-practice state; PMHNPs need collaborative agreements

Illinois:

• IMLC member—expedited licensing available
• Requires separate Illinois Controlled Substance License
• Strong telehealth parity laws; audio-only permitted for mental health when needed
• NP note: Experienced PMHNPs (4,000+ hours) can get Full Practice Authority with limited Schedule II restrictions

Practical Licensing Strategy

Phase 1: Get your first 2-3 states

• Start with your home state
• Add 1-2 IMLC states where you want patient volume (Texas, Florida, Illinois work well)
• Budget $300-800 per state in fees

Phase 2: Expand strategically

• Monitor which states your patient inquiries come from
• Add states based on actual demand, not guesswork
• California and New York require longer planning—start those processes early if you want those markets

Phase 3: Maintain compliance

• Track renewal dates (every state is different)
• Budget for continuing education requirements
• Enroll in each state’s PDMP system for controlled substance monitoring
• Keep malpractice coverage updated for all states

Cost reality: Expect $300-800 per state for initial licensing, $200-500 for renewals every 1-3 years. A psychiatrist with 5 state licenses might spend $3,000-4,000 upfront and $1,500-2,500 annually in maintenance. Still far cheaper than office rent.

Cash-Pay vs Insurance: The $100,000+ Decision

This choice shapes your entire practice: your daily schedule, your income, your administrative burden, and your patient demographics.

Why So Many Psychiatrists Go Cash-Only

The data tells the story: only about 55% of psychiatrists accept insurance, compared to 95%+ of other physicians. Here’s why:

Reimbursement is 22% lower for mental health. Private insurers systematically underpay behavioral health compared to medical/surgical services. A 30-minute med management visit might reimburse $80-100 through insurance vs $150-200 cash. Over a year, that’s a six-figure difference.

Cash rates are substantially higher:

• Initial evaluation (60 min): $300-500 cash vs $120-180 insurance
• Follow-up (15-30 min): $100-200 cash vs $60-100 insurance
• Therapy sessions: $150-250 cash vs $80-120 insurance

Administrative burden disappears. No:

• Prior authorizations for medications
• Claim denials to appeal
• Waiting 2-4 weeks for payment
• Credentialing paperwork every 2 years
• Insurance company chart audits

You set the rules. Want to offer 45-minute appointments? Unlimited patient messaging? Weekend availability? Good luck getting insurance to pay fairly for that.

The Insurance Case

Volume and access. Being in-network means covered patients pay only a copay, dramatically expanding your potential patient pool. This is crucial in:

• Underserved communities where patients can’t afford cash rates
• Building a practice quickly from zero
• Serving diverse populations vs only affluent patients

Steady referrals. Insurance directories drive patients to in-network providers. Primary care doctors preferentially refer to in-network specialists. EAP programs require insurance participation.

Predictable revenue if managed well. A well-optimized insurance practice seeing 15-20 patients daily at $100 average can generate $1,500-2,000/day. Not as profitable per hour as cash-pay, but consistent.

The Hybrid Model (What Many Actually Do)

Smart approach: Start with 1-2 insurance panels to build volume, then transition to primarily cash/out-of-network as word-of-mouth grows.

Or: Accept only higher-paying commercial plans, drop Medicaid and low-reimbursing plans, and supplement with cash patients.

Or: Fully cash but provide superbills for patients with out-of-network benefits (they can get 50-80% reimbursed, you get paid upfront).

New Developments to Watch

Illinois legislation proposes requiring insurers to pay 141% of Medicare rates for behavioral health to address the reimbursement gap. If passed and replicated elsewhere, this could shift the economics significantly.

Telehealth platforms are creating a middle path: they handle insurance billing (or operate cash-pay) and pay clinicians a set rate per session. You avoid insurance hassles but also can’t capture full cash-pay rates.

Making Your Choice

Consider:

• Year 1-2: Can you afford to wait for cash-pay word-of-mouth? Or do you need immediate volume via insurance?
• Your market: Affluent urban/suburban areas can support cash practices. Rural or lower-income areas may require insurance participation.
• Your tolerance: How much does billing paperwork bother you vs limiting your patient pool?

Real talk: If you’re starting from scratch, accepting 1-2 major commercial plans for the first year gives you cash flow while you build reputation. Then you can selectively drop plans or go full cash once you’re at 60-70% capacity. Very few successful psychiatrists accept all insurance indefinitely.

The No-Show Problem and Telehealth’s Solution

Psychiatric practices face particularly high no-show rates—around 30% for initial evaluations, double the rate of other specialties. This destroys your schedule and income.

Why psychiatry has worse no-shows:

• Depression/anxiety makes it harder for patients to keep appointments
• Longer waits between scheduling and appointment (motivation fades)
• Transportation and stigma barriers for in-office visits
• Patients feel better and decide they don’t need help

How telehealth cuts no-shows dramatically:

Studies show virtual visits reduce no-show odds by ~39% compared to in-person care. One psychiatry department saw no-shows drop from 45% to 15% after implementing telehealth.

Why it works:

• No transportation needed—patients join from home
• No time off work or childcare logistics
• Less stigma than walking into a mental health clinic
• Easier to keep appointment when you just click a link

Operational strategies to reduce no-shows further:

1. Automated reminders: Text/email 24-48 hours before. This is table stakes—every platform should offer this.

2. Clear cancellation policy: ’24-hour notice required or $X fee applies.’ Enforce it consistently.

3. Waitlists for last-minute fills: Keep a list of patients wanting sooner appointments; call them when someone cancels.

4. Pre-appointment check-ins: A quick confirmation call or text the day before establishes rapport and commitment.

5. Telehealth platform choice matters: User-friendly systems (one-click join, no downloads) see better attendance than clunky platforms requiring patient tech troubleshooting.

The economics: Each no-show costs you $150-300 in lost revenue. At 20% no-show rate seeing 20 patients/week, that’s $15,600-31,200 in annual lost revenue. Cutting that to 10% through telehealth adds $7,800-15,600 to your bottom line.

This isn’t just about money—it’s about getting care to people who need it. Every no-show is a patient who didn’t get help and another patient who couldn’t get that slot.

Your Telehealth Practice Launch Checklist

Regulatory Foundation

Licensing (covered above)

• ☐ Obtain licenses in target states (3-6 months timeline for most)
• ☐ Join IMLC if eligible to expedite future states
• ☐ Set renewal tracking system (licenses expire every 1-3 years)

Controlled Substances

• ☐ Get DEA registration ($888 for 3 years)
• ☐ Register with each state’s PDMP system
• ☐ Understand current federal tele-prescribing rules (extended through end of 2025; may change)
• ☐ Know state-specific CS requirements (e.g., Illinois requires separate state CS license)

Business Setup

• ☐ Form business entity (LLC/PC as required by state)
• ☐ Get malpractice insurance covering telehealth in all states ($5,000-8,000/year)
• ☐ Open business bank account
• ☐ Consult CPA on tax structure (S-corp election often makes sense)

Technology Stack

Telehealth Platform

• ☐ Choose HIPAA-compliant video solution (Doxy.me, Zoom Healthcare, integrated EHR)
• ☐ Verify Business Associate Agreement (BAA) in place
• ☐ Test patient user experience (one-click join beats downloads)

EHR/Practice Management

• ☐ Select cloud-based EHR with e-prescribing (Luminello, SimplePractice, etc.)
• ☐ Ensure EPCS certified for controlled substances
• ☐ Set up scheduling system with automated reminders
• ☐ Configure patient portal for intake forms

Hardware & Setup

• ☐ Quality webcam and microphone/headset
• ☐ Ring light or good natural lighting
• ☐ Professional background (neutral, clutter-free)
• ☐ Stable high-speed internet (wired Ethernet preferred)
• ☐ Backup internet option (phone hotspot)

Communication

• ☐ HIPAA-compliant phone/text line (Spruce Health, Doximity Dialer)
• ☐ Secure fax if needed for records (many EHRs include this)

Clinical Operations

Patient Intake

• ☐ Create digital intake packet (consent forms, policies, medical history, PHQ-9/GAD-7)
• ☐ Develop telehealth consent form (required in many states)
• ☐ Set emergency protocol (confirm patient location each session, emergency contacts on file)

Scheduling Strategy

• ☐ Define appointment lengths (60 min intakes, 15-30 min follow-ups)
• ☐ Build in 5-10 min buffers for notes/tech issues
• ☐ Consider time zones if multi-state
• ☐ Block personal time (working from home requires discipline)

Policies

• ☐ No-show/late cancellation fee ($50-100 or full session fee)
• ☐ Communication response time (we respond within 1 business day)
• ☐ Prescription refill policy (X days notice, no controlled substances between visits)
• ☐ After-hours coverage plan

Financial Setup

Payment Processing (if cash/self-pay)

• ☐ Set up merchant account (Stripe, Square—3% fees)
• ☐ Decide on payment timing (upfront, day-of, credit card on file)
• ☐ Create superbill template for out-of-network reimbursement

Insurance Billing (if accepting)

• ☐ Apply for credentialing (3-6 months per plan—start early)
• ☐ Set up clearinghouse or EHR billing module
• ☐ Learn telehealth modifiers (95, GT) and place-of-service codes (02)
• ☐ Consider outsourcing billing (5-8% of collections)

Marketing & Patient Acquisition

Foundation (start here—low cost, high ROI)

• ☐ Create Google Business Profile (free)
• ☐ List on Psychology Today directory ($30/month)
• ☐ Build simple professional website (your bio, services, contact)
• ☐ Set up professional LinkedIn profile

Growth Channels

• ☐ Join referral platform for immediate patient flow (pay-per-appointment model)
• ☐ Network with local therapists for med management referrals
• ☐ Connect with primary care docs in your licensed states
• ☐ Consider additional directories (Healthgrades, Zocdoc)

Track Everything

• ☐ Ask new patients ‘How did you find me?’
• ☐ Calculate cost per patient acquired for each channel
• ☐ Double down on what works, cut what doesn’t

Realistic Startup Costs

One-time expenses:

• Licensing (3 states): $1,500-2,500
• DEA registration: $888
• Business formation: $300-800
• Hardware/equipment: $500-1,000
• Website setup: $200-1,000
• Total: $3,400-6,200

Monthly expenses:

• Malpractice insurance: ~$500/month
• EHR/telehealth platform: $100-400/month
• Phone/fax service: $25-50/month
• Marketing (directories): $30-100/month
• Total: $655-1,050/month

Compare this to traditional practice: $3,000-5,000/month in rent alone, plus staff salaries, utilities, furniture, and equipment. Telehealth’s overhead is 70-80% lower.

The Path Forward

Building a telepsychiatry practice isn’t complicated, but it requires navigating regulations, making smart economic choices, and setting up systems that actually work.

Start with the fundamentals:

1. Get licensed in 2-3 states where you want patients (use IMLC for speed)
2. Set up compliant tech (HIPAA video, e-prescribing, scheduling)
3. List on Psychology Today and create a Google Business profile (total cost: $30/month)
4. Join a pay-per-appointment platform for immediate qualified patient flow while your organic marketing builds

Then optimize as you grow:

• Track which states send you the most patients (add licenses strategically)
• Monitor your patient acquisition costs (shift budget to what works)
• Refine your schedule based on no-show patterns and patient needs
• Consider the cash-pay transition once you have steady word-of-mouth

The endgame: A practice that lets you see patients across multiple states, work from anywhere, minimize administrative burden, and actually get paid fairly for your expertise. That’s not a fantasy—it’s what hundreds of telepsychiatrists are doing right now.

The demand is there. Mental health access is at crisis levels in most states. Patients are searching for you today. The question is: will they be able to find you, book with you, and actually show up for care?

Get the infrastructure right, make smart choices about patient acquisition, and you can build a thriving practice that serves patients who desperately need help—while maintaining the income and flexibility you deserve.

Frequently Asked Questions

Do I need a separate license for telehealth?
No. In most states, telehealth is simply a modality of practice—you use your regular physician license. A few states (Florida, Arizona) offer special telehealth registrations for out-of-state providers, but the standard path is obtaining full licensure in any state where patients are located.

Can I prescribe controlled substances via telehealth?
Currently yes, through end of 2025, due to federal COVID-era flexibilities extended by the DEA. After that, rules may require an in-person exam before prescribing Schedule II-V medications via telehealth. Monitor DEA announcements closely. State laws also vary—Florida restricts telehealth controlled substance prescribing except for specific conditions including psychiatric disorders.

What’s the fastest way to get licensed in multiple states?
Join the Interstate Medical Licensure Compact (IMLC) if your home state is a member. You can get licenses in other member states in weeks instead of months. Texas, Florida, Illinois, and Pennsylvania are all IMLC states. California and New York are not—expect 3-6 months for those.

Should I start cash-pay or accept insurance?
If you need immediate patient volume and cash flow, accept 1-2 major commercial insurance plans initially. This fills your schedule faster. Once you’re at 60-70% capacity, you can transition to cash-pay or out-of-network as word-of-mouth referrals build. Pure cash-pay works best in affluent markets or when you have an established reputation.

How much does it really cost to acquire a patient through marketing?
DIY marketing (SEO, Google Ads, directories) typically costs $200-500+ per booked patient when you factor in all costs and time. SEO takes 6-12 months to generate results. Google Ads for mental health keywords run $15-40 per click with conversion rates that push cost-per-booking over $200. Pay-per-appointment platforms charge a standard fee per new patient (often $100-200), but you avoid all the wasted spend and uncertainty.

How do I handle no-shows?
Prevention is key: use automated text/email reminders 24-48 hours before appointments, have a clear cancellation policy with fees, and offer telehealth (which reduces no-shows by ~39% vs in-person). When they happen, charge your policy fee if appropriate, reach out to reschedule, and keep a waitlist to fill last-minute openings.

What’s the difference between Zocdoc and Psychology Today for patient acquisition?
Psychology Today: $30/month subscription, unlimited patient inquiries, you handle scheduling and conversion. Works well if you actively manage your profile. Patients see many providers—you need to stand out.

Zocdoc: Pay-per-booking model (no monthly fee), charges $100-200 per new patient appointment. Patients can book instantly, platform sends reminders. You pay whether patient shows up or not, but it’s guaranteed patient flow vs hoping for directory inquiries.

Many psychiatrists use both: Psychology Today for baseline visibility, Zocdoc or similar platforms when they need to quickly fill openings.

Do I need malpractice insurance for telehealth?
Absolutely yes. Standard malpractice policies usually cover telehealth, but verify your policy covers all states where you’re licensed and practicing. Expect to pay $5,000-8,000/year for full-time psychiatric malpractice coverage. Some carriers offer discounts for part-time or telehealth-only practices.

Can I use Zoom for telehealth sessions?
You must use Zoom for Healthcare (not regular Zoom) which includes HIPAA compliance and a Business Associate Agreement. Regular Zoom doesn’t meet HIPAA requirements. Alternatives like Doxy.me, VSee, or integrated EHR video platforms are also popular. Look for: BAA availability, ease of use for patients, waiting room features, and reliability.

How long does credentialing take for insurance panels?
Typically 3-6 months per insurance plan. Some plans are faster (2-3 months), others slower (6+ months). Start the process early if you plan to accept insurance. Many psychiatrists launch cash-pay first, then add insurance once credentialing completes rather than waiting to start seeing patients.

Key Citations and Sources

1. HHS Telehealth.gov – Licensing Across State Lines
   Official federal guidance on telehealth licensing requirements and state-by-state variations.
   https://telehealth.hhs.gov/licensure/licensing-across-state-lines

2. Pennsylvania Department of State – Interstate Medical Licensure Compact
   Official confirmation of Pennsylvania’s IMLC participation (implemented July 2025) and physician requirements.
   https://www.pa.gov/agencies/dos/department-and-offices/bpoa/boards-commissions/medicine/interstate-medical-licensure-compact

3. Axios – Mental Health Provider Reimbursement Disparity Study
   Research showing private insurers pay behavioral health providers 22% less than medical/surgical services, driving psychiatrists out of insurance networks (March 6, 2025).
   https://www.axios.com/local/chicago/2025/03/06/illinois-mental-health-bill-reimbursement-rates

4. BMC Health Services Research – Telehealth No-Show Meta-Analysis
   Peer-reviewed systematic review finding telehealth reduces patient non-attendance by ~39% compared to in-person care (May 2025).
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063363/

5. Psychiatric Quarterly – Telepsychiatry No-Show Impact Study
   Academic study documenting psychiatry no-show rates dropping from 45% to 15% with telehealth implementation (April 2022).
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9004215/

Additional authoritative sources referenced include: Telehealth Certification Institute (Florida telehealth registration law), Zocdoc provider documentation (pay-per-booking model), Osmind (psychiatry practice marketing data), Florida Board of Nursing (NP practice authority), California Medical Board (licensing timelines), and NP Schools (state-by-state NP scope of practice). All regulatory information verified against official .gov sources or state medical/nursing board websites as of February 2026.

Source:

• https://telehealth.hhs.gov/licensure/licensing-across-state-lines#:~:text=Many%20states%20are%20revisiting%20their,provide%20services%20across%20state%20lines
• https://www.pa.gov/agencies/dos/department-and-offices/bpoa/boards-commissions/medicine/interstate-medical-licensure-compact#:~:text=What%20is%20the%20current%20status,of%20the%20IMLC%20in%20Pennsylvania
• https://www.telementalhealthtraining.com/legal-updates/how-out-of-state-providers-can-register-to-provide-telehealth-in-florida#:~:text=It%20is%20now%20mandatory%20for,face
• https://www.axios.com/local/chicago/2025/03/06/illinois-mental-health-bill-reimbursement-rates#:~:text=providers%2022,or%20find%20a%20new%20provider
• https://www.axios.com/local/chicago/2025/03/06/illinois-mental-health-bill-reimbursement-rates#:~:text=leading%20many%20of%20those%20providers,a
• https://academic.oup.com/healthaffairsscholar/article/2/9/qxae110/7750928#:~:text=Insurance%20acceptance%20and%20cash%20pay,Medicaid%20fee%20schedules%2C%20the%20mean
• https://www.axios.com/local/chicago/2025/03/06/illinois-mental-health-bill-reimbursement-rates#:~:text=insurance%2C%20according%20to%20the%20American,No
• https://www.axios.com/local/chicago/2025/03/06/illinois-mental-health-bill-reimbursement-rates#:~:text=providers%20amounts%20equal%20to%20or,in%20private%20practice%20tells%20Axios
• https://pmc.ncbi.nlm.nih.gov/articles/PMC9004215/#:~:text=studies%20to%20differ%20anywhere%20from,1%5D.%20Patients%20who%20no
• https://pmc.ncbi.nlm.nih.gov/articles/PMC12063363/#:~:text=models%20of%20care%20are%20significantly,attendance%20can%20be%20caused