Trilliant's New Health Economy Report Puts DPC at About 0.5% of Americans. Hint's Published 2025 Figure Is 0.41%.

Primary care visits per 1,000 people grew 0.7% a year from 2019 to 2025. Advanced imaging visits grew 4.9% a year over the same stretch. Those two numbers sit near the center of Trilliant Health’s 2026 Trends Shaping the Health Economy Report, released Oct. 6, and they explain why direct primary care shows up in it at all.

The Brentwood, Tennessee analytics firm calls U.S. health care “a textbook tragedy of the commons” in its press release. Every player, the release says, is “incentivized to maximize its own revenue,” and the system as a whole produces little health for what it costs. DPC gets one sentence in Medical Economics’ write-up of the 141-page report: the model “reached about 0.5% of Americans in 2025, with employers covering 60% of membership costs, according to Hint Health data in the report.”

That sentence will get quoted. The report itself is a free PDF, and its DPC page shows where both numbers moved.

Where the report puts DPC

The placement says as much as the number. DPC gets page 56, inside the report’s “Market Failure” trend, under the headline “Direct Primary Care Is a Niche Model That Signals Failings of the Current System.” The page adds two facts the summary left out: as of 2023, 44% of DPC practices sat in Health Professional Shortage Areas, and its chart counts 2,060 active practices in 2023 against 3,100 in 2026.

Medical Economics runs the DPC line in a section called “Patients look elsewhere,” directly after a 2026 Siemens Healthineers survey the report cites. In it, 49% of patients said they had given themselves a test for an illness or symptom. Another 17% said they had asked for a lab test based on something they saw on social media. In the report that survey sits three pages later, on page 59, in the same Market Failure trend.

The supply side of the report explains the demand. Federal projections it cites put primary care physician supply at 80.4% of demand by 2038. In 2025, 89.1% of U.S. counties were partly or entirely short of primary care and behavioral health clinicians. The family medicine fill rate in the 2026 Match fell to 83.6%, down from 85% a year earlier.

Yalda Jabbarpour, M.D., who directs the Robert Graham Center, gave Medical Economics the plainest version: “The reason that we have modalities of delivering care that are different from the traditional primary care office is because the health care system is broken. It’s because it’s hard for patients to get in.”

So the report treats DPC as a symptom of scarcity. Advocates usually describe it as a payment model. Both readings can hold, but a physician reading this report learns about the waiting room before the membership.

Two numbers, checked against Hint

Hint Health’s April release of its 2026 trends report states the 2025 figure directly: “a density of 409 active members per 100,000 Americans.” That works out to 0.41%. Trilliant’s own chart on page 56 prints the same 409 for 2025, right beside text that says “approximately 0.5% of Americans.” So the rounding is the report’s, and “about 0.5%” is more than a fifth larger than its own chart.

The employer number moved too. Hint’s release says employers “fund the majority (60%) of active DPC memberships.” That counts memberships an employer pays for. The report’s text says “60% of DPC membership costs were covered by employers in 2025,” which is a share of dollars, and Medical Economics repeated that wording accurately. The two shares can diverge whenever an employer covers part of a fee, or when employer-sponsored and individual memberships are priced differently. The same release puts employer-sponsored rates in a “$55–$65 range” for five straight years. It gives no figure for individual memberships, and neither does Trilliant’s page 56, so neither source shows the two shares match.

The denominator matters as well. Hint’s trends page says its analysts compiled data from over 2,700 DPC clinicians and their 1.4 million members. That’s a vendor’s dataset, and the report’s footnote says so: its DPC members are those “on Hint Health’s database with an active membership at some point during the census year.” The page doesn’t say how much of the national market those clinicians make up, and a platform’s numbers aren’t automatically the market’s.

The price gap behind the scarcity

One finding in the report bears on the decision you might be weighing more than the DPC line does. In Chicago, Trilliant’s analysis of price transparency data found hospital-employed physicians received a blended commercial E/M rate of $239 for office visits. Independent physicians received $147. In primary care the gap was the smallest of the specialties studied, $196 against $154. In urology it reached $122.

The report states the consequence itself: “Site-of-service payment differentials unintentionally incentivize hospital ownership over independent practice.” Medical Economics reports that 59.4% of physicians are employed by hospitals, according to Trilliant’s provider directory.

A DPC practice that bills no insurer sits outside that commercial rate schedule. The report’s DPC page doesn’t make that argument. It does document the pressure that pushes independent fee-for-service practices toward selling.

The Open Question

Trilliant’s DPC page ends on a question it doesn’t answer: “Will DPC continue to complement employer-sponsored insurance or become a substitute, with patients dropping insurance coverage to enroll in DPC and assume the risk of catastrophic care?”

Nothing on the page measures it. The chart splits members by whether an employer pays, and no figure on the page says whether those members also carry insurance. The 60% employer share shows who pays for a membership. It doesn’t show who dropped coverage to get one.

What is settled is Hint’s own published count: 409 members per 100,000 Americans in 2025, measured on one vendor’s platform. The same report projects primary care physician supply 19.6 points short of demand by 2038. Hint’s release says membership grew 837% from 2017 to 2025. Even so, at 0.41% or 0.5% of the population, DPC is a small answer to a gap that size.