A Concierge Deal Report Puts DPC in Its Lowest Fee Tier

Membership medicine now has a price map drawn by the people who advise on its deals, and direct primary care sits on the bottom row.

The map is in State of Concierge and Consumer Medicine, 2026, an October white paper prepared jointly by Vector Medical Group, a health care strategy and M&A advisory firm, and the law firm Baker Donelson. It sorts the field into four segments by annual fee. The first is labelled “Standard/DPC”: under roughly $5,000 a year, often billed monthly, with 400 to 600 or more members per physician.

The paper calls that tier the “broadest addressable market.” It places most of the platform building somewhere else. The premium tier, at roughly $5,000 to $15,000 a year and about 150 to 400 members per physician, is “where most sponsor-backed platform formation is concentrated.”

Who wrote it, and for whom

The authors sell transaction advice. Gary W. Herschman co-chairs Baker Donelson’s health care transactions group, and the paper’s own bio says he has negotiated physician group deals from $5 million to more than $250 million. Dana Jacoby founded Vector Medical Group. The paper says it reflects market observations as of September 2026 and that its platform and investor data are drawn from public sources and are approximate.

So read it as a deal team’s view of the market, written for owners who might sell. Its thesis fits on one line: in membership medicine, the asset “is a renewing relationship.”

That view has a clear picture of what a buyer wants. The paper lists four ways value gets built: prepaid memberships, add-on services that “raise revenue per member without raising panel size,” panel discipline, and a brand that outlives the founding physician. The add-ons it names are diagnostics, hormone optimization, weight management, wellness and aesthetics.

A tier wide enough to hold two different businesses

“Under roughly $5,000” is a generous ceiling for DPC. The American Academy of Family Physicians says DPC monthly fees generally range from $50 to $100, which works out to $600 to $1,200 a year. A $5,000 annual fee is about $417 a month.

The panel range lines up more closely. AAFP puts the average DPC panel at 413 patients, near the bottom of the paper’s 400 to 600-plus band.

The ceiling matters most at the HSA line. The paper counts “expanded health savings account treatment of direct primary care arrangements” as a tailwind for the whole category. The federal rules are narrower. Under IRS Notice 2026-5, direct primary care stops counting for HSA contribution eligibility when a person’s total DPC fees for a month exceed $150, or $300 for an arrangement that covers more than one person. A fee above that limit can still be paid from the account, the notice says, but it “will disqualify the covered individual from eligibility for making HSA contributions” while enrolled. The paper’s premium floor of $5,000 a year works out to well over that $150 limit.

The paper itself says the lowest tier is the one “most exposed to employer, ICHRA, and HSA-linked payment rails.” The federal limit points the same way. A member paying more than $150 a month can still spend HSA money on the fee, but can’t keep adding new money to the account.

What buyers check first

The most useful pages for a DPC owner are the ones on diligence, whether or not a sale is ever on the table. The paper says buyers spend most of their time on the durability of the membership base, and it lists what they ask for:

• Retention by cohort, meaning how a group of members behaves in years two, three and five, and what happens at each price increase.
• Conversion yield, meaning the share of a legacy panel that buys a membership, and what each converted member cost.
• Physician concentration, meaning how much revenue follows one name.
• Attach rate, meaning revenue per member beyond the membership fee.

Each of those questions, the paper says, can be answered well only with data “that takes quarters, not weeks, to assemble.” It adds that the data sets come from operating discipline over time and not from a data room “assembled in six weeks.” A DPC owner who has never split renewals by the year a member joined can start that count now.

The paper is also blunt about compliance. “Cash-pay does not mean unregulated,” it says, and it warns that membership fees “generally may not be charged for items and services already covered by a patient’s insurance.” It flags hybrid programs especially, meaning practices that keep billing payors while selling memberships to part of the panel.

The Counterargument

The strongest case against reading this as “capital is passing DPC by” comes from the paper’s own platform tables. One platform, backed by Shore Capital Partners since 2023, is listed with 17 clinics in five states, more than 100 physicians, about 500 members per physician and a “Concierge and Direct Primary Care Model.” Another, a virtual practice funded in 2026 by FUSE and Aurum Partners, is described as a “direct primary care model supported by AI Platform.” DPC-sized panels are already inside the deal flow.

The paper also says concierge medicine, direct primary care and longevity “are converging into a single consumer-health economy.” If that’s right, the tier labels matter less than the paper’s own segmentation suggests.

The point survives, with a concession. Capital is reaching DPC. In the paper’s tables, the DPC capital it lists arrives bundled with a concierge brand or a platform. The playbook the paper describes runs on conversion of large legacy panels, add-on revenue and fees in the thousands. At AAFP’s $50 to $100 a month, a 413-member panel brings in roughly $248,000 to $496,000 a year in membership fees. That is our arithmetic, not the paper’s. The paper’s tables list one high-end platform at a $30,000 base fee per member each year. Those are different businesses. The paper’s own warning applies with more force to the smaller one: revenue-share affiliation “reduces margin permanently in exchange for infrastructure.”