DPC Insider

Direct Primary Care news, analysis, and insights for physicians.

Maine's Insurance Bureau Approved a 15 Percent ACA Rate Hike Last Week. The State Now Has at Least 50 Direct Primary Care Practices.

Maine's insurance bureau approved a nearly 15 percent rate increase for 2027 ACA plans on August 14. For 2026, the state estimated that households keeping the same plan would have faced an average 77 percent premium increase after enhanced subsidies expired. The state now has at least 50 direct primary care clinics — one of the highest rates of DPC physicians per capita in the country, the Sun Journal reported.

Massachusetts House Voted 158-0 on a Primary Care Spending Target of 15% by 2036. The Senate Wants to Get There Six Years Earlier.

The Massachusetts House voted 158-0 on July 30 to set primary care spending targets of 9% by 2030, 12% by 2033, and 15% by 2036. The Senate passed its version in June with a 2030 deadline. Both bills require commercial insurers to make a monthly per-member primary care payment model available — the same payment structure DPC practices have used for years. Conference committee negotiations are now underway.

A National Physician Survey Just Replaced DPC's Decade-Old Price Benchmark. The Average Is Around $98 — and Two-Thirds of Surveyed Physicians Are Women.

The Direct Primary Care Alliance's State of DPC 2026 report — drawing on a physician survey fielded in late 2024 — is the first comprehensive national study of DPC practice economics since the 2015 Eskew and Klink benchmark. Its findings update two data points the industry has relied on for a decade: what DPC memberships actually cost, and who's building the model.

The First Comprehensive Survey of Pediatric DPC Physicians Reached 73 Practices in 26 States. Ninety-Four Percent Report Being Happier Than in Their Prior Practice.

A peer-reviewed survey published in Cureus in May 2025 — the first comprehensive national overview of pediatric DPC physicians — captured 73 practices across 26 states, found that 94 percent of physicians reported being happier than in their prior practice, and found that 70 percent of those practices serve some Medicaid-insured children.

The 2026 DPC Physician of the Year Built Her Practice to Serve Black Women. Her State Has the Second-Highest Black Maternal Mortality Rate in the Country.

Dr. Michelle Cooke won the DPC Physician of the Year Award at the 2026 DPC Summit in New Orleans after founding Sol Direct Primary Care in East Point, Georgia — a practice built explicitly around Black women's health in a state where they die from preventable causes at more than twice the rate of white women.

The Medicare Payment System Has Cut Physician Pay 33 Percent Since 2001. DPC Physicians Left. Now Their Colleagues in Congress Are Trying to Fix What Remains.

On July 14, CMS proposed cutting Medicare physician pay 1.68 percent for 2027—the latest step in a 25-year inflation-adjusted decline. The next day, physician-lawmakers from both parties introduced the Patients First Act to permanently tie Medicare updates to inflation and create a monthly-payment pilot for independent primary care practices.

Premise Health and Crossover Health Completed Their Merger in March. The Combined Company Has Nearly 900 Clinics and Wants the Same Employer Contracts That Independent DPC Practices Do.

The Premise-Crossover merger, announced in January 2026 and completed in March, created the country's largest employer primary care platform — nearly 900 clinics, 400-plus employer clients, projected to approach $2 billion in revenue. Two Health Affairs studies published in 2026 show what private equity does to primary care practices after acquisition: more billing, more patients, and more clinician exits.

All 50 States Have First-Year Rural Health Awards Averaging $200 Million. In Texas, Independent Primary Care Physicians Made the State's Eligible List.

The $50 billion federal Rural Health Transformation Program pays states, not providers — and states decide who the money reaches next. Texas has put independent primary care physicians on a state eligible provider list. Several states have application windows open this month — and the clock to shape how the money flows runs out October 30.

The Enhanced Subsidies Are Gone. In Wisconsin, DPC Practices Are Taking the Calls.

After enhanced ACA premium tax credits expired, Wisconsin's approved 2026 marketplace rates rose 17.4% on average — but what some households pay jumped far more, by as much as 800% for a near-retirement couple just above the subsidy cutoff. DPC practices across the state are fielding new patient inquiries at an unusual rate. Blue Cross Blue Shield says DPC still can't replace the insurance model.