A Rural Primary Care Company Raised $53 Million and Reported an 89 Net Promoter Score. It Bills Medicare.

Three days ago this publication covered a benchmark report putting DPC’s Net Promoter Score at 85, against a range of 38 to 58 for traditional healthcare. On August 18, a company called Hopscotch Primary Care announced a $53 million Series D and reported an NPS of 89.

Hopscotch bills Medicare. It accepts Original Medicare, is in network with Medicare Advantage carriers, and sells itself as primary care for seniors. Its clinics keep a patient relations manager on hand to field Medicare and Medicare/Medicaid questions.

That combination is the reason this funding round matters more than its dollar figure.

What the money bought

Hopscotch was founded in 2021 and now serves more than 15,000 patients through 12 clinical locations. The announcement calls those rural communities across the southeastern United States. Hopscotch’s own locations directory puts all 12 of them in North Carolina, most in the western end of the state, and describes the footprint as “starting in North Carolina.” So this is a single-state chain today, whatever the region it plans to grow into. Run the division and the average site carries at least 1,250 patients, which is a small-format clinic by any standard.

8VC and Town Hall Ventures led the round. New investors include the Autism Impact Fund, Kleiner Perkins chairman John Doerr, Heritage Provider Network founder Dr. Richard Merkin, and the Leon Levine Foundation. Existing backers aMoon Fund, Citi Impact Fund, Alumni Ventures and K2 HealthVentures all returned.

CEO Tim Gronniger came to Hopscotch from Signify Health, where he was chief of value-based care, and before that ran Caravan Health, an ACO enabler for rural health systems. That resume tells you what the company is. This is value-based Medicare, built by people who have done value-based Medicare.

The operating description in the announcement will sound familiar to anyone running a DPC panel: same-day visits, 24 hour access to a patient’s care team, and proactive outreach between visits.

The number, and what it can actually carry

Hopscotch reported its 89 in a funding announcement. No sample size, no response rate, no survey window, no administering vendor. As evidence goes, that is a marketing claim.

The DPC figure is documented somewhat further. Hint Health’s 2026 benchmark surveyed 1,534 DPC patients across 12 clinics, and Hint sells membership and billing software to DPC practices, so it is also a party with something to sell.

So the honest read is that two self-interested numbers landed four points apart, and nobody should treat that gap as measuring anything. A Medicare seniors panel and a mixed DPC panel are different populations answering under different conditions.

What survives the caveats is narrower and more interesting. Hint gives the 38 to 58 range for “traditional healthcare” and never says what that covers: no definition, no source, no sample, no description of how those practices deliver care. Anyone quoting the range is filling in the comparison group themselves. Hopscotch takes insurance money and lands nowhere near it, which is a reason to want the definition before leaning on the gap.

Where the return comes from

The line in the release that investors actually bought sits after the patient scores. Hopscotch says its management of medical expenses has produced medical loss ratio improvement of more than 25 percentage points for patients over their first two years, and that its western North Carolina operations are already profitable.

That is the whole thesis. The headline metric is medical expense, though the release never names the baseline that improvement is measured against. It carries no figure at all about what patients pay. How that improvement turns into Hopscotch revenue stays private: the announcement never describes the contract, so a savings split, a capitated rate and a risk arrangement all remain live possibilities. Whichever it is, the small panels and the 24 hour access are doing financial work in that model, not decorative work.

DPC arrives at similar clinical behavior by a different route. Removing insurance from the exam room removes the volume incentive directly, without needing any payer contract to reward it. Both designs end up with a physician who has time. Only one of them requires a payer relationship to work.

Chief Medical Officer Dr. Aditi Mallick described the model as “built around the patient, not around the visit.” A DPC physician could have said that sentence, and many have.

Where DPC Fits

Rural primary care is where DPC has been quietly winning arguments. The economics are favorable, hospital closures leave real gaps, and a physician in a small town can fill a panel on reputation alone. This publication covered two physicians putting $2 million into a clinic in Canton, New York on August 2, and Maine reaching at least 50 DPC practices on August 19.

Hopscotch is going after the same kind of town with $53 million and Medicare paying the bills, and it can serve the population DPC has the hardest time reaching. Most seniors pay no Part A premium at all, because they or a spouse paid Medicare taxes long enough while working, generally at least 10 years. Asking them to add a monthly fee on top of coverage they already earned is a hard sale.

For a physician choosing where to open, that changes the map more than it changes the model. A market with a Hopscotch clinic is a market where patients have already been taught to expect same-day access and a doctor who calls them. Meeting that expectation is table stakes there. The pitch that has to do the work is ownership, scope, and the absence of anyone between the physician and the patient.

The capital is arriving in rural primary care either way. What it funds is still an open contest.