Direct Primary Care Explained & Our Pricing

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Direct Primary Care (DPC) is a broad primary care practice model to provide membership-based healthcare for a recurring fee (AAFP, n.d.).  It has become a growing trend within the healthcare setting and allows providers to offer a chosen scope of services.  It circumvents excessive requirements needed for health insurance contracts by offering wellness, preventative, chronic, and acute care through recurrent membership fees.  Patients are billed depending on the membership or subscription agreement.

Memberships can include specific medical tests, procedures, and laboratory that are inhouse and possibly include outsource services such as imaging.  DPCs are gaining popularity with over 1,200 DPC practices currently providing care across the nation (Texas Public Policy Foundation, 2020).    

Traditional primary care clinic panels average around 2,000 patients per provider whereas DPC panels have an average of 700 patients.  The smaller provider panels allow more time being spent with patients and better patient outcomes through increased provider availability.       

The model reduces operating cost and administrative work by eliminating insurance claims by opting out of insurance participation.  Providers have increased time with their patients as research has shown an average of 35 minutes spent with patients (Texas Public Policy Foundation, 2020).  The model is designed to promote more provider-patient communication, time spent with the patient, and provide more access to care.      

The DPC model has become increasingly appealing to providers as they can set their own panel loads, offer flexible scheduling, and virtual appointments. DPC practices do recommend individuals combine a “wraparound” high deductible insurance policy with their membership to cover emergencies such as hospitalizations, surgery, specialist care, or catastrophic events (Hsieh, 2021).