MaineHealth Launches Trellis: A Membership-Based Primary Care Model

MaineHealth has introduced Trellis Health, a membership-based primary care system designed to transform traditional primary care delivery by bypassing insurance billing and focusing on direct patient access. Members pay a monthly fee starting at $109 to receive expedited appointments and enhanced communication with healthcare providers including phone and email consultations. Initially launched in 2024 for MaineHealth employees with around 700 participants, Trellis Health recently expanded availability to the broader public and employers. The program supplements rather than replaces conventional primary care and is not covered by Medicaid or Medicare for membership fees.

MaineHealth CEO Dr. Andy Mueller emphasizes that this model sacrifices the conventional fee-for-service, high-volume visit payment structure in favor of comprehensive, patient-centered care. Trellis employs an interdisciplinary primary care team including physicians, nurse practitioners, a behavioral health specialist, physical therapist, pharmacist, and nurse to provide in-house services and reduce reliance on specialists. Early outcomes show a 47% reduction in specialist utilization among Trellis members compared to traditional care patients.

Employees who transitioned to Trellis report more thorough consultations and less rushed visits, contributing to improved healthcare management such as chronic conditions and physical therapy. The model is poised for expansion beyond Portland to additional Maine locations including Brunswick and Biddeford, with a capacity to scale.

Trellis Health's structure aligns with the direct primary care model but attempts to broaden appeal through MaineHealth's established hospital system resource base, potentially facilitating employer sponsorship and wider adoption. Experts highlight that enhanced primary care coordination improves care quality and lowers downstream healthcare costs, albeit sustained reform historically faces cyclical adoption challenges.

The membership arrangement encourages preventive care and non-visit engagements, countering traditional reimbursements that prioritize billable visits and often pressure primary care providers to maintain high patient volumes. Staff report improved provider work-life balance and decreased burnout under this model.

National analyses note parallels with similar initiatives, such as Vanderbilt University’s system, reinforcing a trend towards payer and provider experimentation with value-based primary care transformation. Scaling this approach depends on demonstrating financial viability and delivering measurable system savings while improving patient access.

MaineHealth executives anticipate Trellis will positively impact their financial sustainability by redefining reimbursement models to truly value primary care's contribution. This initiative represents a strategic response to systemic inefficiencies in healthcare payment and access, positioning membership-based primary care as a potential emerging standard that supports both provider well-being and patient care quality.