Mending Quit the Insurance Business to Go All-In on DPC

Industry News by DPC Insider
#employer DPC#DPC infrastructure#Mending#self-funded employers#ACA
Sources: Mending to no longer serve as health insurance carrier amid its national direct primary care push · Mending Launches Mending Access, Bringing Integrated Direct Primary Care to TPAs and Self-Funded Employers Nationwide

Most of the insurers leaving the ACA market in 2026 are doing it because the math stopped working. Mending has a different explanation.

Becker’s Payer Issues reported this week that the company will no longer operate as an ACA health insurance carrier after 2026. Mending built health plans in Maine and Oklahoma with DPC membership bundled into coverage. Those plans are done. Two existing ACA carriers in those states will continue running DPC-inclusive products, but without Mending on the insurance side. The company’s focus from here is Mending Access, the DPC integration platform it launched in January for self-funded employers and TPAs.

What Mending Access Does

Mending Access connects DPC practices directly into employer health plans and TPA workflows. Practices get a path into employer benefit ecosystems without negotiating contracts one employer at a time. Administrators get eligibility management, automated data exchange and utilization reporting. Payment processing fires only when an employee actually uses DPC.

The numbers from the first five months are concrete. The platform reached over 100,000 covered lives across employer-sponsored plans, expanded from two states to twelve and expects to be active in more than 25 states by the end of 2026. Practices can join at no cost.

Jay Kempton, CEO of The Kempton Group Administrators, described what moves employers: “Employers want the accessibility and physician relationship that DPC offers, but they also need transparency.”

That reporting piece is what turns a benefit into a business case. Benefit administrators need to show utilization, cost impact and whether employees are actually using what’s offered. Mending Access is built around that requirement.

Why Give Up the Insurance License

Running an insurance carrier is its own business. Actuarial risk. State licensing across multiple markets. Full ACA compliance machinery. Every hour spent there is an hour not spent on the platform.

There’s also the customer problem. Mending’s ACA plans in Maine and Oklahoma put the company in direct competition with the carriers and TPAs that Mending Access now needs to sell to. Dropping the carrier role turns some of those former competitors into potential customers.

“As a DPC technology-focused company, we’re better suited to provide a national network of direct primary care, which can be integrated into any employer health plan or TPA,” the company said.

Jeff Yuan, co-founder of Mending, described the platform’s purpose this way: “That foundation has allowed us to build a bridge between employers who want better primary care for their employees and the DPC doctors already delivering it.”

The strategic logic runs in both directions. Staying in the carrier role would have capped how many partners Mending Access could realistically sign. Exiting it removes that ceiling.

What This Means

For DPC practices, Mending Access is a distribution channel with a specific trade-off. Employer-sponsored membership typically means lower individual fees in exchange for volume, with a TPA or employer handling enrollment rather than direct-to-patient acquisition. Whether that works depends on the practice’s model, its local employer base and how actively the employers enrolled through the platform promote the benefit. The no-cost entry for practices keeps the exploration cost low.

For physicians considering DPC, a platform like Mending Access changes one part of the picture. The traditional employer DPC route has required either finding employers to contract with directly, which takes time and scale, or relying on a local DPC network to broker those relationships. A national TPA-integrated platform is a third path: practices that join get visibility to a pool of employer-covered patients who already have DPC access activated in their benefits.

For the broader industry, the more telling signal is what Mending was willing to give up. The company built a real ACA product in two states, proved the model and then decided the technology platform was worth more. The argument is that DPC adoption through employer health plans will grow faster than any single company can capture by staying in the carrier role.

That logic is easier to follow this year. At least six insurers have announced exits from ACA markets in 2026, and self-funded employers are looking harder at direct primary care as a way to keep primary care costs stable when coverage options shrink. Whether 100,000 covered lives in five months is the beginning of that growth or a ceiling depends on how many employers actually activate the benefit rather than just offer it. That’s the harder problem, and no platform has fully solved it yet.