Corpus Christi Approved Up to $5.7 Million for Direct Primary Care. Read the Guarantee It Got Back.

Corpus Christi bought direct primary care for its police officers, firefighters and civilian staff. The city council approved it on August 18, and the ceiling is $5.7 million over three years.

The vendor put out a press release about it on September 24. The release is thin. The public file behind it is not.

Employer DPC deals get announced constantly and documented almost never. This one had to clear a city council, so the agenda memo, the funding lines, the selection process and the exact wording of the performance guarantee are all posted where anyone can read them. That is a rare look at what an employer signs when it buys direct primary care.

What the $5.7 million covers

The council passed Motion M2026-083, agenda item 26-1043, authorizing a three-year service agreement with Next Level Urgent Care through the Choice Partners Cooperative, a national purchasing cooperative run by the Harris County Department of Education. No member of the public spoke.

FY 2027 carries $1,772,664 from the Fire, Police and Citicare health benefits funds, subject to budget approval. FY 2028 and FY 2029 are each budgeted at $1,963,668. Those three lines add up to exactly $5,700,000. Pricing runs on a per-employee-per-month rate, and the memo says the rate is guaranteed for the full three years.

Eligibility is wide. Active employees, retirees and covered dependents on any city medical plan qualify, across the civilian, police and fire populations, and they can be seen at any Next Level location in Texas at zero out-of-pocket cost. The memo puts the employee-side value at an average of $83 per primary care visit and $163 per urgent care visit.

The program also replaces something. City employees currently use an Employee Health and Wellness Clinic on the first floor of City Hall, managed by Concentra, open weekdays from 7 a.m. to 5 p.m. and closed on city holidays. Next Level runs seven days a week from 9 a.m. to 9 p.m. with virtual care around the clock. Its first Corpus Christi clinic opens September 30 at 4717 S. Padre Island Drive. The August memo had given October, and it puts a second location in mid to late 2027.

The memo says a search was completed with help from the city’s benefits consultant, and that the city reviewed proposals from four national, state and local providers. Human Resources partnered with the Police Officers Association and the Firefighters Association on the evaluation, and the memo reports all parties agreed Next Level offered the most value.

The savings math the council was shown

The slide deck presented to the council projects $3.39 million in total cost savings to the health plans, with net savings of $1.68 million after program costs. The vendor estimates 2:1 savings in years one and two, rising to 3:1 in year three.

The staff memo carries those same two figures and calls them the city’s estimated annual savings. A few lines on, it sets a lower bar for the budget. The city is budgeting for 1:1 savings in the first year and expects no cost increase compared with current spending on the City Hall clinic.

So one document holds an estimate and a budgeting assumption, and they are not the same size. The contract protects a third thing, smaller than either.

What the guarantee actually promises

The memo states it twice, in two different places, and the two statements do not match perfectly.

The version at the end of the memo’s background and findings section: “NLUC guarantees the City will never pay NLUC for more than the value of services provided to members on an annual basis, or NLUC will reimburse the difference to the City.”

The procurement version is more specific. “Performance is measured based on total fees paid by the Client to NLUC for the PRIME program compared to the total value of PRIME-covered services rendered, as documented in NLUC’s utilization reports.” Non-covered services and third-party charges are excluded. The reconciliation is based on aggregate program performance and is “processed within 30 days of contract term completion.”

Read that carefully. The guarantee is a floor on the value of care delivered, not a floor on medical spending. If the city pays $1.77 million in FY 2027 and members use $1.8 million worth of covered care, the guarantee is satisfied, whether or not a single emergency room visit gets avoided. Utilization is the measure, and utilization is the thing an unlimited-access membership is designed to increase.

Two more details matter. The count comes from the vendor’s own utilization reports, and nothing in the public record establishes at what prices those services are valued. And the two sections keep different clocks. The background and findings section describes the payment-versus-value comparison as an annual one, while only the procurement section puts a date on the reconciliation itself, at 30 days after the contract term finishes. A three-year wait for a true-up is a different financial instrument from an annual one.

None of that makes the deal bad. The city expects no cost increase against its existing clinic spend, and it gets seven-day hours and 24/7 virtual care in place of weekday business hours. That is a real gain in access. The point is narrower: the $3.39 million is a forecast, and the guarantee is not protecting it.

The definition question, answered by a purchasing department

DPC Insider covered Next Level Prime on August 3, when Douglas Farrago, MD, argued that an urgent care chain selling a membership product under the DPC label is DPC in name only. That post ended on an unresolved worry: the definitions the field quotes would not stop it, and a benefits manager comparing two proposals would have no way to tell the difference.

Corpus Christi is what that looks like in practice. The city reviewed four proposals, with a benefits consultant and two labor associations taking part, and chose this one. The council slide deck lists “Direct Primary Care” as a best practice and names Houston, Austin and San Antonio as municipalities moving the same direction.

The memo’s own service list makes the omission clear. Chronic disease management, labs, immunizations, X-rays for acute injury, telemedicine, health coaching. Elsewhere the memo adds seven-day clinic hours and access to any Next Level location in Texas. Nowhere does it name a physician who will know the patient.

One more constraint deserves attention from anyone who assumes municipal benefits decisions are made freely. The memo’s alternatives section warns that declining the agreement could put the city in violation of its collective bargaining agreements with fire and police, because the cost of the employee clinic “is part of the formulary budgeting process for employee premiums.” The on-site clinic sits inside the premium budgeting the memo ties to those contracts. Staff did not treat walking away as a clean option, they treated it as a possible breach.

The Open Question

The record establishes what Corpus Christi will pay and what it hopes to save. It does not establish how the guarantee gets settled.

Everything turns on the phrase “total value of PRIME-covered services rendered.” Value against what price? A published charge master, the Medicare fee schedule, the rates the city’s health plan would otherwise have paid or Next Level’s own list prices? The memo does not say, and the price sheet listed among the supporting documents is not part of what the council posted publicly. Until that basis is known, nobody outside the transaction can check whether the guarantee is a hard constraint or an accounting identity.

There is a moment when this gets settled, and the file does not say when it arrives. The reconciliation the procurement section describes lands within 30 days of the end of the three-year term, and no posted document gives that term a start date or an end date. Three years is a long time to run a program before anyone can audit the promise that sold it.