When city of Charlotte workers get sick, they don’t have to wait weeks for a primary care appointment or shell out a co-pay for an urgent care visit. Instead, they can often be seen on the same day, at no charge, at one of six local clinics run by Marathon Health.

Like a growing number of other employers, the city has embraced a health care model known as direct primary care that sidesteps traditional health insurance for its 9,000 workers and 3,500 retirees. Under the arrangement, the city pays Marathon a flat monthly fee for each employee; in turn, employees are guaranteed same-day or next-day doctor’s appointments.

Think of it “like a gym membership for health care,” said Dr. Meaghann Bernardy, regional medical director for Marathon Health’s East region.

At the appointments, employee

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