Primary Care Office Visits Under Employer Plans Averaged $142 in 2023, Up From $125. People Made Fewer of Them.

A primary care office visit for someone with employer coverage carried an average price of $142 in 2023, counting what the plan paid and what the patient paid. In 2019 the average was about $125. And over those same four years, the average person with job-based coverage made fewer of those visits.

The figures come from the Health Care Cost Institute’s 2023 Health Care Cost and Utilization Report, released October 13, and the national data table published with it. HCCI studies claims for people younger than 65 with employer-sponsored insurance. Its headline finding covers the whole system. Spending per person grew 18.8% from 2019 to 2023, reaching $6,743. Average prices grew 17.7%. Utilization grew 1.8%.

“The top line was its prices, not utilization, that are causing healthcare costs to go up,” HCCI president and CEO Katie Martin told Managed Healthcare Executive.

Managed Healthcare Executive’s write-up doesn’t get to primary care. The 2019 to 2023 primary care trend is in the data table.

The primary care row

HCCI sorts evaluation and management services into types. One row in the table is primary care office and outpatient visits billed as professional services. These are its 2019 and 2023 values. The price and spending figures are totals, the plan’s payment plus the patient’s:

Primary care office visits	2019	2023
Average price per visit	$125.43	$141.74
Visits per 1,000 people	1,731	1,458
Spending per person	$217.11	$206.71
Patient out-of-pocket per person	$51.61	$43.44

By DPC Insider’s arithmetic, the average price rose about 13% while visits per person fell about 16%. Spending per person on these visits slipped by about 5%. Patients’ out-of-pocket share of that spending shrank from about 24% to about 21%.

The report’s own text puts primary care at 25% of evaluation and management spending and 26% of those visits in 2023. Its $142 average sits above behavioral health visits at $132 and below specialist visits at $162.

Where the office visits went

A 16% drop in office visits reads like people stopped seeing their primary care doctor. The table can’t support that reading.

Professional evaluation and management use grew 13% over the same five years, the report says. Telehealth went from about 26 visits per 1,000 people in 2019 to 811 in 2023, at an average price of $128. HCCI counts telehealth on its own line. The published table doesn’t say how many of those virtual visits were with a primary care clinician, so some share of the missing office visits may simply have moved to a screen.

Specialist office visits fell too, from 879 per 1,000 to 773. That fits a shift in how visits happen across medicine, with primary care one part of it.

One more limit applies to every per-person figure here. HCCI’s averages include people who used no care. The report says non-users make up about one quarter of the population for medical services. The $206.71 is spread across everyone on the plan, including the many who never booked a visit that year.

Setting it beside a membership fee

Monthly DPC membership fees generally range from $50 to $100, according to the American Academy of Family Physicians. Multiplied out, that’s $600 to $1,200 a year per member. Spending on primary care office visits averaged $206.71 per person in 2023, plan and patient payments combined. Take out the $43.44 patients paid and the plan’s share comes to about $163, by DPC Insider’s arithmetic.

On the visit line alone, then, a membership costs an employer more than the office visits it would replace. The case for DPC to a self-funded employer has to be made somewhere else in the ledger: in referrals, emergency visits and hospital stays. That argument needs evidence of its own, beyond this report.

Martin’s own read of the data points toward hospitals. “If we’re going to make a dent, we have to figure out where we can make changes in hospitals,” she told Managed Healthcare Executive.

What This Means

If you might be building an employer DPC proposal this fall, assume the employer can find this number too. It’s in a free public spreadsheet. A self-funded employer that sees about $207 a year in primary care office spending next to a $600 membership will ask what the difference buys.

A general answer about access won’t close that gap. The rest of the $6,743 per person is where your proposal lives, and the employer’s own claims are the strongest evidence you can bring to it.

The price trend gives you one honest point. The average price of a visit rose about 13% in four years, on a schedule the employer never set. A membership fee changes when the practice changes it, and the employer sees it coming.