DPC Is Doubling Year Over Year and Still Isn't a Household Name. Four Physicians Took That Problem to a National Stage.

The average direct primary care membership costs about $98 a month nationally, according to Direct Primary Care Alliance survey data cited from a conference stage this month. Actual pricing varies by practice and location. The physicians sharing that number think the model has a bigger problem than price: most patients have never heard of it.

That was the throughline of a panel at PrimaryCare26: See the Possibilities, a conference hosted by Primary Care for America, recapped by Medical Economics on July 27. Sara Pastoor, M.D., M.H.A., who leads primary care advancement at Elation Health and practices DPC in San Antonio, moderated. On the panel: Kelsey Smith, M.D., an Oklahoma family physician and president of the Direct Primary Care Alliance. Michael Hobbs, M.D., a pediatrician who founded Lakes Pediatrics in Minnesota. And Sabina Singh, M.D., co-founder and chief medical officer of Anovia Health in Wisconsin.

“DPC started as sort of this fringe, grassroots movement, and now has taken the country by storm,” Pastoor said, describing physician and patient adoption as doubling or tripling year over year.

Smith put her own exit from insurance-based medicine in blunter terms. Her old practice felt like a slow-moving barge that was starting to list. DPC was a smaller boat she could actually steer.

The Employer Proof Point

Singh made the strongest case that the model already works at scale. Anovia Health went from zero to 17 near-site and employer clinics serving roughly 40,000 patients in five years, she said. Wisconsin’s consolidated, expensive hospital market gave the company its opening.

Anovia works directly with insurance brokers and third-party administrators. Its client list includes manufacturers, banks, school systems and county governments. Employers want two things, Singh said: healthier employees and a benefit they can explain in one sentence.

The retention driver is the same thing DPC physicians cite everywhere. Personal relationships and unhurried time build the trust that changes health outcomes, which is where the savings come from. Singh pointed to one client with 153 employees that saved $684,000 in 2025, a 14 percent reduction in cost per employee based on comparing full episodes of care between Anovia users and non-users.

Numbers like that get employer attention. They still don’t make patients search for a DPC practice by name, which is the gap this panel kept returning to.

Pediatrics Shows Where the Model Strains

Hobbs runs one of the few pediatric DPC practices in the Minneapolis area, and his segment was the least triumphant. Between 40 and 50 percent of American children are covered by Medicaid at any given time, he noted, and roughly 60 percent will be covered by it at some point before age 18. Preventive visits and vaccines are already paid for. Selling a membership on top of that is a hard conversation.

Vaccines are the sharpest edge. Hobbs called them the biggest friction point in the field, because a practice that doesn’t bill insurance has no built-in way to fund them. Last year’s federal tax law let patients spend HSA dollars on DPC memberships, a change we covered in July, but that does nothing for families without the underlying coverage.

His single biggest policy ask: universal vaccine coverage for all children regardless of insurance status. “If you can’t get the patients, you can’t keep the doors open,” he said.

What It Would Take to Go Mainstream

The panel’s honest answer is that the physician side of the pipeline is as underbuilt as the patient side. Singh named the golden handcuffs keeping doctors in employed roles: noncompete clauses, loan repayment obligations and the security of a salary. Her proposed fixes include DPC exposure in medical school and employed-physician roles inside DPC organizations, so a doctor can practice the model without also running a business.

Smith described the field as still in its pioneering phase. The founders were bushwhackers clearing a trail. Today’s physicians are settlers following paths already marked, and the next wave should include doctors who simply want to practice medicine.

On policy, Smith wants the HSA momentum to continue. “I think the idea of using HSA dollars and putting those in the hands of the patient and allowing them to spend them where they see fit is a true innovation,” she said. Singh called Medicare and Medicaid the biggest remaining challenge, since patients cycle between employer coverage and public programs and practices want to keep the relationship through every transition.

The five-year visions were specific. Smith wants every medical student to know DPC exists and to see primary care as a first choice rather than a fallback. Hobbs wants the model to become “such a household name that demand outpaces the number of physicians available to practice it.”

What This Means

For physicians already running DPC practices, this panel signals where the industry’s energy is going next: toward patient awareness. The model has employer traction, federal HSA recognition and organized advocacy. What it lacks is patients who walk in asking for it by name, and that gap is now the stated priority of the field’s own leadership.

If you might be considering DPC, take the barriers named on that stage seriously. The golden handcuffs are real. So is the emergence of employed-DPC roles at organizations like Anovia, which barely existed as an option five years ago.

For resident physicians, Smith’s five-year goal is aimed squarely at you. The field’s leadership wants DPC in the medical school conversation before the first employment contract gets signed. Whether that happens through curriculum or through word of mouth, the window where DPC was something you had to discover on your own appears to be closing.