Curative Is Pitching Texas DPC Practices. One Doctor Read the Contract.

Competitor Watch by DPC Insider
#insurance#network contracts#Texas#DPC model#cautionary
Sources: Curative Wants in On DPC With a Few Stipulations

You get an email from a health insurance company. They want you in their network. The plan offers $0 copays, $0 deductibles, and $0 out-of-pocket costs for members.

The contract says membership fees cannot be required for plan members to access covered services.

That’s the offer Curative has been sending to DPC practices in Texas.

The Numbers

Curative sells fully insured health plans and frames the arrangement as complementary to DPC: a way to bring insured patients in without the usual billing friction. The fee schedule pays 75-90% of Medicare rates. A 99213 office visit yields $93. A chest X-ray gets $21. Most DPC practices charge $50-75 for that same X-ray at cash prices.

When physicians pushed back on the reimbursement math, Curative’s response was the same offer managed care plans have made for three decades. Higher patient volume will make up the difference.

That argument is exactly why many DPC doctors left fee-for-service. Volume-based math requires seeing more patients per hour, which means shorter visits, which means worse care. Most DPC physicians left that trade specifically to practice differently.

What Dr. Porter Found

Cliff Porter, MD, runs Texas Direct Medical Care in College Station. He received Curative’s cold outreach alongside other Texas DPC physicians and analyzed the terms.

His description: “an insurance wolf in DINO clothing.” DINO, short for DPC In Name Only.

Porter’s breakdown points to three problems. First, reimbursements that fall below standard DPC cash pricing. Second, an explicit prohibition on requiring membership fees from Curative members. Third, prior authorization denials with limited transparency on the reasoning behind them.

Together, those terms would convert a DPC practice into a low-overhead insurance-billing operation. Monthly membership revenue, controlled panel sizes, freedom from per-visit billing: all gone. A DPC practice runs on memberships, not per-encounter claims. A contract that bans membership fees for plan members converts the practice into something else.

Why Insurers Are Paying Attention

DPC’s cost profile attracts payer interest for the same reasons it attracts physicians. Practices with panels of 400-600 patients deliver primary care at a fraction of the per-member-per-month cost of traditional offices. Employers have been acting on that math for several years. More insurers are now trying to do the same.

The problem is that DPC works because the practice answers to its members, not to a payer network. Physicians set their own panel sizes. They bill monthly. The moment a payer’s contract overrides those conditions, the practice starts looking like traditional primary care with the billing software changed.

Curative isn’t the first insurer to approach DPC practices with deals that borrow the aesthetics of the model without its structure. As DPC membership numbers grow, more will try.

Red Flags to Watch in Any Network Deal

Any network participation agreement deserves a careful read. The terms that signal trouble:

  • A prohibition or restriction on membership fee requirements for plan members
  • Reimbursement rates tied to Medicare schedules, especially below 100%
  • Prior authorization requirements for services DPC practices don’t typically pre-clear
  • Open-network enrollment terms that remove your control over panel size

Douglas Farrago, MD, published Porter’s analysis on DPC News and described it as a cautionary example for the DPC community.

What This Means

For physicians running DPC practices, the Curative story is a reminder that not every offer framed as DPC-compatible actually is. The contract’s key clause, “Membership fees cannot be required for Curative members to access covered services,” is not a technicality. It removes the practice’s economic foundation.

If you’re considering the DPC transition, this is worth knowing before you sign anything. A network agreement signed at launch can lock you into terms that make the membership model unviable before you’ve had a chance to build it. Most DPC practices operate on a simple structure: one payment type, one patient relationship, no payer in between. Adding a payer with its own fee schedule and access requirements breaks that structure.

For residents evaluating DPC as a career option, Curative’s approach reflects something real about where the model stands. It’s large enough now that insurers are trying to route around it rather than ignore it. More pitches like this will arrive as membership numbers climb. Reading contracts carefully has always been part of running an independent practice. That part hasn’t changed.