Direct Primary Care news, analysis, and insights for physicians.
A Medscape commentary from a Chicago direct primary care physician credits 45 uninterrupted minutes with connecting what was already in a patient's chart. Its 6.6-year figure matches a 2024 preprint. The peer-reviewed version reports 6.8 years and never addresses whether longer visits shorten the delay.
Harbor Health agreed to buy 27 Village Medical clinics in Greater Houston. Its individual and family plans open for HealthCare.gov enrollment there on November 1.
Kenneth Qiu, M.D., who led the DPC Alliance's national practice survey, told Medical Economics that moonlighting generally requires being opted into Medicare, and that many founders then choose not to see Medicare patients. Federal opt-out rules show why the choice is all or nothing.
Minnesota's final 2027 rates average 17.4 percent higher and take effect January 1, MNsure's window runs November 1 to January 15, and the state's new direct primary care section does not take effect until August 1, 2027.
A Laurel family physician asked Maryland to test DPC alongside marketplace coverage. Since January, a bronze Exchange plan can count as HSA-eligible, and a qualifying DPC membership of $150 a month or less no longer blocks HSA contributions.
Josh Umbehr told Sen. Roger Marshall that mandating price tags is easy and getting lower prices is hard. S. 2355 also carries a billing-notice rule for any provider that bills a patient.
Act 173 gives the Blueprint for Health director until January 15, 2027 to define primary care provider, and to say what payment changes would let Vermont's existing monthly payments cover routine primary care for attributed patients in participating plans.
CMS and the SBA rebranded ICHRA as the CHOICE Arrangement on September 3. Groom reads the core structure of the arrangement as unchanged, and the bill that would write the new name into the tax code passed the House in December, with the Senate not having advanced it as of September 10.
CMS's 2027 fee schedule proposal would pay a modifier 25 office visit at 50% when it shares a day with a global procedure that pays more. The final rule is expected around November 1.
Brown University Health has added a $2,400-a-year premium membership tier to its primary care practice, citing the same physician shortage Rhode Island's attorney general pointed to in April when he said concierge medicine was hurting the rest of the patient pool.
Marquis MD introduced the founding physicians at its Boca Raton practice on October 7 and sells three membership tiers, but neither its website nor its launch announcements list a price.
The federal guidance is permissive about when a direct primary care fee is collected and strict about what the arrangement covers. A member who declines the extras cannot rescue terms that reach past primary care.
Trilliant Health's 141-page 2026 report gives direct primary care one page under its Market Failure trend. The chart on that page shows 409 members per 100,000, the text says about 0.5%, and Hint's 60% share of memberships becomes 60% of membership costs.
Community Choice Credit Union members can join Hy-Vee Health Exemplar Care for $75 a month, a new distribution channel that sits between employer and retail DPC.
A Harvard physician argued in the Washington Post that billing patients for portal messages could backfire. Studies from Mayo Clinic and UCSF measured what happened when health systems tried it, and who stopped writing.
A new Cureus study from a single pediatric membership practice reports that nearly every surveyed parent felt less anxious. Here is what a 43-parent survey can and cannot show.
Columbus direct primary care physician Teresa Lovins will lead the Indiana State Medical Association in 2027, and the group's own policy manual has pushed for HSA access, insurance carve-outs and a Medicaid pilot for DPC.
Trellis Health opened in Brunswick on September 28. One of its three enrollment channels, a Mending Health plan that covered the membership in full, stops selling in Maine in 92 days.
The September 2 stopgap moved the discretionary health center deadline and left the Community Health Center Fund alone. It runs out December 31, and the patients a lapse would reach are mostly not patients a DPC membership can absorb.
H.R. 10444 would make it unlawful for any entity not majority-owned by clinicians to own a medical practice, then carves hospitals out of that prohibition. The provision DPC physicians would actually feel is the one that voids non-competes.
Minnesota Statutes 62Q.20 was enacted on May 26 inside an appropriations bill, delayed to August 1, 2027 by a second bill signed the same day, and it makes a violation unprofessional conduct under the chapters that license physicians and nurses.
New Kent Direct Care published four age-banded membership tiers before opening, and three land above the $150 monthly limit that governs HSA contribution eligibility.
Nebraska's LB1119 required the state employee insurance program to offer DPC plans. Four reports to the Legislature show why enrollment never cleared 2 percent.
Hendry County Schools is buying employee primary care straight from the county hospital. Prescriptions from the hospital pharmacy are part of the benefit, and IRS Notice 2026-5 pulls prescription drugs other than vaccines out of what a direct primary care service arrangement can cover.
A new coalition of employers, physicians and health care companies wants Congress to open up health plan data, limit contract terms, and change the direct primary care rules. Two federal rules answer to that last phrase, and they point opposite ways for a small practice.
H.R. 1162 and S. 3298 would let state Medicaid programs pay a fixed monthly fee for primary care, an idea the House approved by voice vote in March 2024. Both are still in committee, and the 119th Congress is down to a December funding deadline.
The City of Corpus Christi approved a three-year direct primary care contract worth up to $5.7 million and projected $3.39 million in annual savings. The performance guarantee in the public file promises something narrower than that.
Cost Plus Wellness posts every contract in full. Six Direct Primary Care listings were up as of September 24, and their rate sheets show exactly where the $150 HSA cap falls.
HB 1562 passed the New Hampshire House 181-149 in March and died without a Senate vote. It lifts an all-payer rule in RSA 151, which binds licensed facilities. The state's direct primary care law sits in a different chapter, and RSA 151 says it doesn't require licensing physicians' offices.
A New Hampshire clinic charges $50 to $100 a month, and the nurse practitioner who opened it says the model is reachable without insurance. The 2026 HSA contribution break runs through a health plan the uninsured don't have.
A judge let Dr. Nyasha Spears open Amity Creek Primary Care over her former employer's noncompete. Aspirus appealed, and the hearing is set for Oct. 8.
Oregon's House Bill 2540 took effect January 1, 2026, requiring most health benefit plans to credit direct patient payments toward deductibles and out-of-pocket maximums. DPC Frontier reads it as reaching DPC membership fees, and the statute's conditions decide how much of one actually lands.
New Jersey's public employee health plans include a no-copay direct primary care benefit at eleven Marathon Health clinics, and the commission agendas, the NJEA's statement and the news accounts of both 2027 premium fights never mention it.
Great Plains Family Medicine, a Kansas direct primary care practice founded in 2015, was named September Small Business of the Month by the Hutchinson/Reno County Chamber. Its own website publishes the prices and panel numbers behind a practice that opened in 2015.
A study in Medical Care Research and Review recalculated primary care shortage designations with nurse practitioners included, and 80.2% of the 970 counties it could match fell to a score of zero. HRSA builds those designations on physician counts alone.
AMMP calls itself a big tent for concierge medicine, direct primary care and hybrid models. Its founding partner tier is Cleveland Clinic, Mass General and Ohio State Wexner, and institutional membership does not open until later in 2026.
Origins DPC in Warner, New Hampshire publishes fees of $50 to $100 a month by age. The reporting around it points at a DPC customer the growth data rarely counts.
Cimri Medical has opened in New Jersey with a sliding scale and no Medicaid patients. Kore points to state regulation. DPC Frontier flags a different obstacle across most of the country: who may order a lab.
Nara Health raised $14 million to rebuild employer health plans with AI, and direct primary care shows up as one of four cost levers whose savings the company never breaks out.
Two direct primary care doctors published warnings three days apart this month, one about government money and one about mission drift. The federal rules that made memberships HSA-eligible also wrote down what a qualifying arrangement can cover.
University Health tracked its ACA-covered patients into a new fiscal year and puts the combined revenue loss at $37.5 million. A week earlier the same newsroom reported that not taking insurance has become a selling point for some Kansas City doctors, one of whom advertises on a billboard on Troost Avenue.
Private Medical's seventh office opens October 1 in Greenwich, Connecticut, with annual memberships starting at $45,000 for adults and a cap of about 100 patients per physician. The AAFP puts the average DPC panel at 413 patients and monthly fees at $50 to $100.
OffPlan launched September 1 in three metro markets at $145 a month for adults, five dollars under the federal ceiling that protects HSA contributions for a membership covering one person.
Vermont quit the CMS AHEAD Model after renegotiation capped extra federal health funding at $10 million, cutting what it could reinvest in primary care. Some of its clinicians are now selling memberships, in a state with no DPC statute.
Senators Sheldon Whitehouse and Bill Cassidy announced the Pay PCPs Act of 2026 on September 9. S. 5269 would appropriate $10 billion, let HHS pay primary care a prospective per-member-per-month amount inside Medicare and halve cost sharing for patients who designate a primary care provider, and drop participating clinicians out of MIPS.
Birch Health is opening in Kingsport at $75 a month plus a $150 annual fee, in the home market of Ballad Health, whose certificate of public advantage expires by statute on June 30, 2028.
Mississippi posted the lowest ACA effectuation rate in the country in 2026 at 61 percent. Mississippi Today reports that a set of the state's family physicians have moved to direct primary care, in a state that never expanded Medicaid and legalized DPC agreements in 2015.
Fort Smith's chamber of commerce named Dr. Justin Voris its 2026 Physician of the Year, judged on criteria that include growth alongside quality.
HMSA's new panel rules drop patients with no recent claim and pay only one primary care provider per patient per year, four months short of the January deadline for its retreat from fixed monthly payments.
In a September 1 Healio report, Health Affairs lead author Jane Zhu asked whether direct primary care increases overall primary care capacity or reallocates it toward patients who are able to access these models. Her own paper records the settings clinicians entering concierge and DPC practices left. It never counted how many patients they were carrying.
Mercer's preliminary 2027 survey of more than 1,800 employers projects the steepest one-year benefit cost increase in two decades, and its planning guidance names direct primary care as one of four ways to make low-cost primary care easy to reach.
Healthspan DPC billed itself as northeast Missouri's first direct primary care practice when it launched in La Belle in 2024. It has since opened a second location in Canton.
Doximity's 2026 Physician Compensation Report draws on nearly 23,000 physician surveys collected in 2025. A separate June 2026 poll of more than 600 physicians conducted alongside the report found 46 percent are considering early retirement, up from 34 percent the year before. The compensation dataset found pay grew just 2 percent and the surgical-to-primary-care pay gap widened after three consecutive years of modest narrowing.
At a September 1 interim hearing on health care affordability, a Direct Primary Care Coalition witness told Texas lawmakers the model may not work in rural areas, then asked lawmakers to make practices easier to open.
Imagine360 and Health Rosetta launched Choice360, a self-funded employer health plan with integrated solution partners spanning direct primary care, mental health, telehealth, and oncology. The plan opens in select markets January 1, 2027, offered through Health Rosetta's accredited advisor network.
LegacyMD launched September 3 as a majority physician-owned platform for concierge and DPC practices, backed by $17.1 million in OakNorth loans and committed facilities and two founder-led groups in Indianapolis and Long Island.
A March fire took Palisade Direct Primary Care before it ever opened. Dr. Jay Allen reopened at a new Duluth address on September 1, and the six months in between show what a membership practice actually needs to run.
MDVIP released its 2026 patient satisfaction survey on August 25, drawing 68,801 member responses and reporting a record 79 Net Promoter Score and 91 percent renewal intent. A separate Arcadia analysis found 15 percent fewer ER visits and 13 percent fewer hospitalizations than expected for Medicare patients in MDVIP-affiliated practices. Understanding what those numbers measure requires understanding what MDVIP is.
Hint Health's 2026 DPC Trends Report found that 60 percent of active DPC memberships on its platform are now employer-funded, the highest share in the dataset. The milestone raises a question DPC's founding premise didn't fully anticipate.
A Hint Health whitepaper tells direct primary care practices to add lifestyle and functional medicine and sell part of it as an add-on. The outcome evidence behind it was collected somewhere else.
Imagine360 and Health Rosetta launched Choice360 in July: a self-funded employer health plan that combines direct primary care with mental health, telehealth, and oncology as integrated solution partners, built for forward-thinking advisors and plan sponsors, using Health Rosetta's advisor support model, for the 2027 plan year.
Corunna Public Schools pays Plum Health $90 a month per employee for an on-campus direct primary care clinic, extending primary care to more than twice the staff its insurance reaches.
The Toolkit by My DPC Story surveyed 131 DPC practices across 40 states on their most essential non-EHR tools. When forced to pick just one tool, physicians chose a patient messaging app over the billing platform that won the billing category outright.
UW Health, brokerage M3 Insurance and employer cooperative The Alliance open a Rockford clinic to more employers on Jan. 1, 2027, marketed as a direct primary care plan in a state with no DPC statute on the books.
H.R. 9257, the Primary and Behavioral Health Care Access Act of 2026, would require private insurance plans to cover three primary care and three behavioral health visits per year without copays or deductibles. Introduced June 11, it sits in three House committees. The problem it targets is the same one DPC was built around solving.
A JAMA analysis of Medicare's G2211 longitudinal care code found specialists billed 43 percent of 26 million first-year claims, while primary care physicians used it on a larger share of their eligible visits.
About 2,500 Blue Cross Medicare Advantage members lose in-network primary care at Cooley Dickinson on October 1, the second Massachusetts network exit in nine months. Medicare's opt-out calendar is why direct primary care will not catch most of them.
Hint Health's 2026 Direct Primary Care Trends Report, drawing on data from 2,700-plus clinicians and 1.4 million members, found that California, Illinois and New York are now among the top five states for DPC clinician growth. The model is entering the markets where it was supposed to be hardest to build.
Oklahoma placed Mending's ACA marketplace business under state supervision in July, citing the company's finances, weeks after Mending announced it was leaving the market after this year.
A peer-reviewed Cureus study of 73 pediatric direct primary care physicians across 26 states is the first national data on what the model looks like in pediatrics: solo practices, small panels, early income cuts, and a Medicaid finding the data cannot account for.
After her employer clinic discontinued services, Dr. Nyasha Spears filed suit against Aspirus St. Luke's when the health system attempted to enforce a 25-mile non-compete. A Minnesota judge blocked it, citing the state's documented primary care shortage. She and a co-founder opened Amity Creek Primary Care in Duluth's Lakeside neighborhood in April 2026.
Apta Health announced a nationwide expansion of its cash-pay employer health plan on August 26, built around unlimited direct primary care and negotiated cash pricing. The only result it cites comes from a single company.
A Health Affairs study by researchers at Oregon Health & Science University found that DPC and concierge practice sites grew 83.1 percent from 2018 to 2023 — but the physician share of their clinical workforce fell from 67.3 percent to 59.7 percent as advanced practice clinicians entered at a faster rate.
Wyoming's 2016 DPC statute exempts agreements made by any health care provider, and the state requires no physician supervision of nurse practitioners. Wyo Roots Health opened in Sheridan on July 20, launched by a family nurse practitioner.
A Savannah Magazine feature profiled concierge medicine and direct primary care as a single category. The federal HSA definition that took effect January 1 draws a much narrower line, and neither practice it profiled describes itself as loosely as the coverage does.
Dr. Michelle Cooke won the 2026 DPC Physician of the Year Award at the DPC Summit in New Orleans after founding Sol Direct Primary Care, the first DPC practice in southwest Atlanta, built explicitly around Black women's health in a state with some of the country's highest documented maternal mortality rates.
The Hint Health 2026 Direct Primary Care Trends Report found 837 percent growth in DPC membership since 2017, drawing on data from 1.4 million members. The same report puts DPC density at 409 members per 100,000 Americans. Whether the model can reach the scale that 'becoming the norm' would require is a different calculation from whether it has grown fast.
Hopscotch Primary Care announced a $53 million Series D on August 18 and reported a Net Promoter Score of 89, above the 85 that Hint Health's 2026 benchmark reported for DPC practices. Hopscotch accepts Medicare, which complicates the assumption that only membership medicine produces those patient scores.
A February 2026 study in Health Affairs Scholar used health administrative data from 12,726,325 Ontarians and found that people unattached from primary care for two to five years had 85 percent higher odds of all-cause mortality compared with those continuously attached for fifteen or more years. The study is from Ontario, not the United States, and the findings carry specific limits, but the association is large and drawn from a population-scale cohort of 12.7 million.
A December 2025 Health Affairs study tracked concierge and direct primary care practice sites and found corporate-affiliated practices grew from roughly 9 percent to one-third of the broader market in five years. Because about 60 percent of the clinicians in the study billed Medicare, most of those clinicians appear to be in concierge or hybrid practices rather than standard DPC, and the study cannot separate them.
Slate's new consumer explainer on membership medicine cites 78.4% clinician growth since 2018, and that number counts two very different models as one.
The Hint Health 2026 DPC Patient Experience Benchmark Report surveyed 1,534 DPC patients across 12 clinics using the Person-Centered Primary Care Measure and reported an 89 percent overall score. The report cites a 2025 JABFM study of 78 conventional practices for the 84 percent traditional-care figure, using the same instrument. Different response rates and populations mean the 5-point gap takes more interpreting than it first appears.
In a new op-ed, GoodRx CEO Wendy Barnes called the direct primary care HSA carve-out narrowly limited and asked Congress to widen it to other health care memberships. That narrowness is written into the statute: primary care only, no prescription drugs beyond vaccines.
A board certified pediatric endocrinologist opens Rural Island Medical in Wrangell, Alaska on Sept. 1 and is weighing a DPC membership, which puts Alaska's 2024 direct health care agreement statute up against how rural practices actually work.
A Forbes analysis named family medicine, geriatrics and sleep medicine as the least-discussed physician shortages, with the reimbursement system's weighting toward procedures as a structural driver. Direct primary care bypasses that payment system at the practice level.
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.
The Massachusetts House passed a primary care spending bill in late July, with the same 15 percent destination as the Senate but a 2036 deadline instead of 2030, plus a new prohibition on AI-only coverage denials. A conference committee now has until January 5, 2027 to reconcile them.
What Secretary Kennedy called the federal government's first major health center expansion since 2019, $102 million for 415 new sites, targets the same primary care access problem DPC is solving, but through a completely different economic model. Here is what the distinction means for DPC physicians and patients.
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.
The Direct Primary Care Alliance's State of DPC 2026 report, drawing on a physician survey fielded in late 2024, is the first national study of DPC practice economics at this scope 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.
Aligned Marketplace raised $20 million in new investment, with the Series A led by Venrock, to sell self-insured employers access to more than 3,000 independent primary care clinics. Several of the clinic groups it has publicly named are value-based care companies, urgent care chains, and onsite employer clinic vendors, and the contract underneath ties payment to engagement and measured outcomes rather than a flat membership.
A peer-reviewed survey published in Cureus in May 2025, the first 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.
Governor Healey signed Executive Order No. 657 setting a goal for the state's Medicaid program to reach 12 percent primary care spending by 2028, without waiting for the legislature's conference committee to finish reconciling the spending bill. Massachusetts is now running executive, regulatory, and legislative tracks simultaneously.
Solstice Health reported 381% revenue growth from 2022 to 2025 on memberships priced between $39 and $79 a month. The company also sells surgery, labs, infusions, and hyperbaric oxygen, and the price list is worth reading alongside the ranking.
A November 2025 Commonwealth Fund survey found U.S. primary care physicians report burnout at nearly four times the rate of their Dutch counterparts. Administrative burden, rather than panel size, is the primary driver, and DPC is structured to remove it.
Aesto Health, a data migration and archiving vendor storing records on Everside Health's behalf, was breached. The filings reached state attorneys general on July 31, and South Carolina's breach notice list alone accounts for 80,622 residents.
A new CMS demonstration covers Wegovy, Zepbound (KwikPen), and Foundayo for eligible Part D beneficiaries at a $50 copay per fill through December 2027. The prescribing physician does not need to be enrolled in Medicare, consistent with existing Part D prescriber rules, which means DPC physicians are already eligible to prescribe into it.
Buried in the CY 2027 Medicare Physician Fee Schedule proposed rule is a request for information asking whether Original Medicare should pay primary care as a monthly prospective amount covering an interval of care. The phrase direct primary care never appears in it.
On July 9, Hint Health replaced its separate products with a single unified platform built in three tiers (Launch, Pro, and Scale) and added secure in-platform messaging and an iOS app for clinicians.
Four Medscape commentaries on direct primary care in July 2026 were authored by the same Chicago physician. The most recent, a brief video by Dr. Rajdeep Dhami, is on what she wishes she'd known before starting a DPC practice.
Next Level Urgent Care sells Houston employers a membership product staffed like urgent care, and Douglas Farrago, MD, reports the chain was behind a Houston Business Journal article promoting DPC. He calls it DINO. Neither of the two definitions the field quotes clearly excludes it.
Dr. Thushyanthan Pathmalingam and Dr. Thivisa Rajagopal have served St. Lawrence County for seven years. Now they are building North Core Medical — a purpose-built direct primary care clinic in Canton, NY — a $2 million commitment to bringing the membership model to a rural corner of northern New York State.
East Texas practice MyMD Select joined holding company Timshel Health on July 30, its second direct primary care deal in two years. The capital structure behind it is different from the private equity model DPC physicians have been warning about.
MyMD Select, a five-office direct primary care practice in East Texas, has joined Timshel Health, a search-fund holding company that says its investors are not waiting on a near-term exit.
A 2026 DPC industry trends report found employers now fund the majority of direct primary care memberships for the first time in the model's history. Medical Economics has devoted a full edition of its Insider series to explaining the model to physicians who haven't switched yet, and in July called DPC 'at an inflection point.'
At the PrimaryCare26 conference, the DPC Alliance president, an Elation Health primary care lead and two practice founders laid out what it will take to make direct primary care a household name.
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.
A Medical Economics article this week captures a shift in how DPC advocates are framing the model: not just as a career alternative, but as a systemic answer to the primary care physician shortage.
The NC State Health Plan built its 2026 Preferred Provider benefit around independent primary care. The Plan says the only way to become a Preferred Provider is through three clinically integrated networks. Additional phases are expected to be considered by the Board, and that's where DPC has an opening.
BestDPC's July 2026 directory shows Direct Primary Care clustering hard in Texas and Florida while whole states barely register, complicating the industry's 'national movement' story.
Delaware Senate Bill 1, which requires insurers to spend 11.5 percent of medical costs on primary care, became law four months after hospital lobbyists tried to kill its rate cap provision.
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.
Choice360 packages DPC as a standard component of a self-funded employer health plan and distributes it through 200-plus benefits advisors, live for the 2027 plan year.
Dr. Sana Siddiqui left a Concord hospital system to open VitalCare Internal Medicine, a women-centered direct primary care practice built around the midlife and menopause care that short insurance visits rush. Her timing lines up with a wave of insurers and startups betting menopause is the next women's health market.
Josh Umbehr of Atlas MD breaks down the real economics of a direct primary care practice, and the overhead gap that makes the model work.
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.
With roughly 1.4 million members, DPC covers about 0.4% of the U.S. population — and industry projections put the 1% mark within reach by 2030. The constraint on its growth has shifted from patient demand to physician supply.
The Improving Seniors' Timely Access to Care Act passed the House Ways and Means Committee unanimously on July 15, requiring Medicare Advantage plans to report denial rates and implement electronic prior authorization. DPC practices have operated without any prior authorization since day one.
A June op-ed argues that private equity has found what it wants in direct primary care: recurring cash-pay revenue. Here's the ownership data driving the concern.
The ACO Primary Care Flex Model is a five-year CMS experiment that pays a prospective monthly fee in place of fee-for-service reimbursement for most primary care — the same structural logic DPC has run on for a decade. Congress spent this week proposing a version of that idea. CMS has been paying under one since January 2025.
Weave launched an authorized integration with Elation Health that auto-syncs patient and appointment data, aimed squarely at the disconnected tools independent and DPC practices run every day.
A new CMS demonstration program gives Medicare patients access to GLP-1 weight-loss drugs for a $50 monthly copay — and prescribers can participate without being enrolled in Medicare, a detail directly relevant to DPC practices.
SONATA raised a $7M seed round from Lux Capital to offer physician-led preventive care memberships combining whole-genome sequencing, blood biomarkers, and ongoing physician access, positioning itself between data-only testing services and traditional concierge medicine.
Dutch researchers tracked 100,450 patients across 48 general practices and found that duration of care — not just visit frequency — drives meaningful reductions in urgent hospitalizations and costs. The finding isolates the mechanism that DPC practices are built to deliver.
The bipartisan Patients First Act of 2026 includes a five-year Medicare hybrid payment model that pays primary care providers a monthly fee per attributed patient in lieu of fee-for-service for those services, the same payment structure DPC practices already use.
The One Big Beautiful Bill made DPC memberships HSA-compatible starting January 2026. IRS Notice 2026-05 defined exactly which arrangements qualify — and three conditions determine whether yours does.
MI Partner Health is expanding its direct primary care model into MVP Athletic Club locations across West Michigan, starting with a Kentwood gym this month.
A Cureus study of a multi-physician pediatric DPC network found that 69 percent of member families avoided at least one emergency department visit—and saved a minimum of $1,171 per year—by texting, calling, and sending photos to their doctor directly.
The DPC Alliance surveyed 465 physicians for its 2026 State of DPC Report, putting the national average membership at $98.46 per month and revealing that two-thirds of DPC doctors are women.
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.
Plante Moran published employer guidance recommending direct primary care as the final layer of a self-funded health plan strategy, a sign that DPC has entered the mainstream benefits-consulting playbook.
Amazon One Medical launched a nationwide GLP-1 management program in April with transparent pricing and pharmacy integration. Twelve days after the Medicare Bridge went live, here is how DPC practices are positioned in the GLP-1 landscape.
Dr. Aaron Neisen runs a DPC practice in northeast Missouri and works ER shifts at a rural hospital. He recently lobbied Congress for rural hospital funding, then announced a second Healthspan DPC clinic in Canton.
Grove Family Health in Leonardtown, Maryland wins the St. Mary's County Chamber of Commerce 2026 Emerging Business Award, as Health Affairs data shows nurse practitioners now make up 40% of the DPC workforce.
A new MedCentral survey finds departure intent among physicians jumped nine points in a single year. Direct primary care practices are reporting a meaningfully different experience.
Jared Dashevsky, MD, outlines a 100-patient subscription pulmonary practice modeled on DPC in a new HLTH article, signaling the direct-pay model's expansion beyond primary care.
A Virginia family medicine physician published a data-backed response to the ten most common criticisms of the direct primary care model, citing HRSA shortage data, the Milbank 2026 report and a JAMA quality-measure analysis.
The House Education and Workforce Subcommittee heard testimony from DPC Action president Chad Savage and Nomi Health CEO Mark Newman on employer savings through direct contracting, with data showing up to 29% cost reductions.
ALEC's health policy director argues states should pass model legislation exempting DPC from insurance regulation as 5.8 million Americans face losing ACA coverage.
A June 2026 KevinMD essay by Dana Y. Lujan maps specific private equity firms and deals reshaping direct primary care ownership, from Goldman Sachs Asset Management to Charlesbank Capital Partners.
Dr. Cory Annis used an AI scribe at her North Carolina DPC practice for two years. The clean SOAP notes it produced revealed the invisible cognitive work that 45-minute visits make possible.
Nebraska launched Medicaid work requirements May 1. Montana follows July 1. CMS projects 2.3 million people will lose Medicaid coverage by FY2027. Here is what that means for primary care access — and where DPC fits.
Early 2027 rate filings show ACA marketplace premiums rising 6.5% to 22.4% depending on the state, with carrier exits mounting and enrollment already down millions from 2025 peaks.
Two Cureus studies surveyed 73 pediatric DPC physicians and 59 member families, finding high satisfaction, a documented income curve, and $1,171 in annual healthcare savings avoided per family through telehealth.
A bipartisan House bill would require hospitals and insurers to publish prices by 2028 with escalating fines, mandating what DPC practices have done since inception.
The same law that opened DPC memberships to HSA users in January added an 80-hours-per-month work requirement for Medicaid expansion adults. States have to be running it by January 1, 2027, and some will start sooner.
A physician cataloged every coordination failure in preparing for cataract surgery. His KevinMD list is a point-by-point case for DPC.
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.
Rep. Eric Burlison's Great American Healthcare Plan proposes eliminating the $150/$300 monthly limits on DPC membership fees as HSA-qualified expenses.
A February 2026 report from the Milbank Memorial Fund, Robert Graham Center, and Physicians Foundation found that adults with chronic disease who have a usual source of primary care have nearly 54% lower total health care spending. The phrase 'usual source' is doing the real work — and it points directly to what DPC delivers.
Iowa House File 2434 takes effect July 1, barring health insurers from denying coverage or charging more on specialist referrals made by DPC providers outside their network.
CommunityCare, owned by Saint Francis Health System and Ascension St. John, is partnering with Mending to carry DPC-embedded ACA marketplace plans forward in Oklahoma beginning January 2027.
The 2026 DPC Summit runs July 16–19 at the Hyatt Regency New Orleans, co-hosted by AAFP, ACOFP, FMEC, and the DPC Alliance. Three learning tracks, hands-on procedural workshops, and 23.5 CME credits — arriving at a moment when the DPC model has arguably become mainstream.
Starting July 1, Medicare Part D beneficiaries with obesity and qualifying conditions can access Wegovy, Zepbound, and Foundayo for a flat $50 per month. DPC physicians can prescribe under the program without Medicare enrollment — but a prior authorization step is required.
A pharmacists' group has called a town hall over Express Scripts dropping a rural Pennsylvania pharmacy from its network, and a DPC physician and Mark Cuban's Cost Plus Drugs are on the panel.
New York's independent practice framework for experienced nurse practitioners — the basis for a wave of NP-led direct care offices — was set to sunset July 1. The health budget signed May 28 lifted the deadline. The bill to make the framework permanent is still in committee.
Federal student loan changes from the One Big Beautiful Bill Act cap medical school borrowing at $50,000 per year starting July 1, 2026. For residents weighing DPC, the financial calculus on practice ownership just shifted.
Marathon Health and Lantern linked employer primary care to specialty surgery coordination. Their pilot produced a 37% to 100% increase in referrals into Lantern's network, a 47% increase in surgeries completed or safely avoided, and 53% savings against standard network surgical rates.
Hint Health's 2026 Direct Primary Care Trends Report documents 837% membership growth since 2017 and a milestone that's new: employers now fund the majority of active DPC memberships — and the fastest growth is happening in California, Illinois, and New York.
A Charlotte pediatrician grew a house call DPC practice from 8 to 200 members in 18 months, with an 85% retention rate and 36% adult conversion from pediatric households.
The Massachusetts Senate voted on June 18 to require that 15% of total healthcare spending flow to primary care by 2030. Commercial plans put 6.6% of their dollars into primary care in 2024, down from 6.9% in 2022, and the state publishes no all-payer figure to set against the target. The fight plays out inside insurance. DPC never needed to have it.
A new startup is packaging direct primary care with transparent specialty pricing and catastrophic coverage into a single employer benefit, raising $2.5M to prove the model works.
The 2026 World Cup is bringing an estimated 1.2 million international visitors into the most complex healthcare market in the world. DPC's cash-pay model was already built for this.
Massachusetts has no dedicated DPC law and restricts physician dispensing more than most states. A bill backed by the Massachusetts Medical Society would change both.
A market report puts the DPC sector at $59.68 billion. The 2026 DPC Summit is five weeks out. And Wisconsin shows what DPC looks like when a bill clears the legislature and dies at the governor's desk.
ICHRAs let small employers hand employees a stipend and step back from managing group health plans. DPC fits cleanly into the resulting coverage stack under new 2026 rules.
The DPC-HSA rule addressed tax friction, not the navigation barriers that keep patients out. Six months in, front desks are still fielding the same questions.
Mending is exiting its ACA health insurance carrier role after 2026, dropping the insurer side to focus entirely on Mending Access, its DPC integration platform for self-funded employers and TPAs.
Marathon Health is expanding employer-sponsored primary care across 41 states, and its new CEO came from Paradigm after more than 15 years at Optum. Here's how the model works and what independent DPC physicians should understand about it.
A new PAI and Avalere Health report tracking physician employment from 2018 to 2026 finds 82% of U.S. physicians now work for a hospital or corporate entity, with the last two years adding 48,100 more employed physicians at a steadier pace than the six years before them.
The American Medical Association published a balanced direct primary care guide for residents during its annual meeting week in Chicago, following the AAFP's similar guide in March.
Elation Health acquired Aster, an AI startup that built a voice agent for front-office automation, as part of a push to build an agentic operating system for primary care.
Revenue Procedure 2026-24 confirmed 2027 DPC fee caps stay at $150 per individual and $300 per family. Here's what that means for your practice.
The Cost Plus Drugs founder's proposed family-of-five model includes a $200/month direct primary care line. A recording of his conversation with a DPC physician comes to the DPC Summit in July.
Mark Cuban's Cost Plus Wellness connects self-funded employers directly with healthcare providers via published contracts. He also just sat down with a DPC physician to talk about employer health benefits ahead of the DPC Summit in July.
In a Medical Economics interview published May 28, Atlas MD co-founder Josh Umbehr describes a new 2026 patient type: people quitting their insurance mid-cycle because the premium became unaffordable, and landing at DPC as the most financially workable option left.
The AAFP's 2024 Direct Primary Care Study found 94% of DPC physicians satisfied with their practice versus 57% of non-DPC physicians — a 37-point gap, drawn from 374 responses to a survey that went looking for DPC doctors.
Congress proposed giving VA-enrolled veterans a direct primary care option outside the system in February 2025. The bill sits in committee as wait times worsen in key specialties and VA staffing shrinks.
A May 2026 Health Affairs study from Brown University found private equity-acquired primary care practices expanded their workforce and patient volumes. What the researchers explicitly couldn't assess is exactly what DPC is designed around.
AdvocateMD opened its fifth location in Sun Prairie on May 21. The ribbon cutting drew more people than the practice's founder expected — and it says something about demand for DPC in communities where insurance-based care is the only option.
Sunshine Pediatrics launches July 1 in Woodbridge, Virginia: a mobile DPC practice where a nurse practitioner visits sick children at home for $50 per month per child.
Four physician-researchers published in JAMA a proposal to pay primary care practices directly, outside insurance. That's the DPC model. Nobody in the article said so.
A 2020 employer study compared a DPC health plan to a traditional PPO side-by-side. The hospital utilization numbers were striking. So are the limitations.
An insurance company is cold-calling DPC practices with network deals that ban membership fees and pay 75-90% of Medicare rates. A Texas physician broke down the terms.
Hint Health surveyed 1,534 DPC patients across 12 practices and found an 89% PCPCM score and a Net Promoter Score of 85 — plus one result that tells the real story about how the model creates value over time.
Amanda Gaskin turned pandemic-era frustration into Lake County's first direct primary care practice, reaching half her first-year patient goal in just 30 days.
As Direct Primary Care attracts corporate investment and employer adoption, a DPC physician is raising an uncomfortable question: are small, solo, and diverse practices being written out of the movement they built?
As employer money floods into DPC and platforms build infrastructure for scale, a 2014 DPC pioneer argues the movement is losing track of the physicians who built it.
Six weeks after clearing committee, Delaware SB1 still hasn't reached a Senate floor vote — blocked by hospital lobbying over a provision that would cap reimbursement at 250% of Medicare rates.
In 28 states with full NP practice authority, nurse practitioners are adopting the DPC membership model — flat monthly fees, limited panels, no insurance billing. A Rhode Island practice is pre-enrolling members right now.
Income predictability and patient recruitment are the two questions physicians ask before switching to DPC. The 2026 data makes both easier to answer.
H.R. 1162 and S.3298 would clarify that state Medicaid programs may pay for direct primary care arrangements. An earlier version passed the House by voice vote in 2024, but that Congress expired. Both bills are sitting in committee.
A prominent health policy economist argues in The Hill that the One Big Beautiful Bill's DPC-HSA provision stopped short — the Americans who need DPC most live in rural communities and they're on Medicare and Medicaid.
The nation's largest insurer is eliminating prior auth for select services by year's end. DPC doctors stepped off the prior auth treadmill years ago. Here's what the gap says about where primary care is heading.
The AHA's new PREVENT calculator reclassifies cardiovascular risk for more than half of U.S. adults. Adopting it could mean an estimated 14.3 million fewer U.S. adults receiving or recommended for statin therapy.
Medical Economics is asking whether DPC worsens physician shortages. The data shows a more complicated picture than either side wants to admit.
Mansion Global covered concierge medicine as a luxury lifestyle trend with fees up to $50,000 a year. Most DPC practices charge under $100 a month. The framing gap matters.
The One Big Beautiful Bill's HSA provision took effect January 1. Michigan companies are expanding direct primary care offerings and new matching services are launching to meet the demand providers expected it to unlock.
Medical Economics, the 100-year-old physician business publication, is devoting its May 12 digital issue entirely to direct primary care. The mainstream framing matters — DPC is being covered as a real career option, not a fringe experiment.
The Blue Cross Blue Shield Association publicly criticized Direct Primary Care models on local news, even as 2026 premium increases are driving a surge in consumer interest.
A DPC physician argues that practices have real bargaining power with aggregators and employers, and shouldn't act like the smaller party in their own market. The argument matters as more contracts hit physicians' inboxes.
A generational staircase is forming: 10% of boomers, 20% of Gen X, 30% of millennials, and nearly 40% of Gen Z lack a primary care doctor. Urgent care chains are rushing to fill the gap. DPC practices should be paying attention.
Nossaman LLP's new legal primer on membership medicine highlights the critical regulatory differences between DPC and hybrid concierge models that physicians need to understand.
Kyna Fong's back-to-back recognition by Becker's Hospital Review and EY reflects Elation Health's growth to 50,000 clinicians and 24 million patients, and signals that DPC infrastructure is earning mainstream credibility.
TytoCare's AI-powered eardrum analysis earned FDA De Novo classification, creating an entirely new device category. For DPC practices leaning on telehealth, remote diagnostic tools like this expand what's possible without an office visit.
Dr. Samir Qamar, who co-founded one of America's first DPC companies, just launched a free AI health companion that connects to his virtual direct primary care practice.
Medicare's Advanced Primary Care Management codes pay doctors a monthly per-patient fee for 24/7 access and care coordination, mirroring the DPC model at lower rates with more rules.
Women make up 55% of medical school enrollment but face 27% higher burnout and leave medicine years earlier than men. A DPC physician argues the model directly addresses the factors driving them out.
Hint Health's 2026 Trends Report reveals employers now pay for 60% of active DPC memberships, with 837% membership growth since 2017 and stable pricing that traditional insurance can't match.
Rising health insurance costs in Maine are pushing families toward direct primary care and health sharing plans, highlighting growing consumer demand for alternatives to traditional coverage.
A new CMS proposal could waive the 15-year-old ban on physician-owned hospitals for a bundled payment model, signaling a broader shift toward physician autonomy that mirrors DPC's own fight.
A Harvard-led study finds concierge and DPC clinicians grew nearly 80% from 2018-2023, while critics warn the trend worsens primary care shortages for everyone else.
The DPC Alliance's Pediatric DPC Conference 2026 in Savannah drew the AAP's past president as keynote speaker, signaling that direct primary care is no longer just an adult medicine story.
As ACA enrollment drops and millions skip premium payments, direct primary care offers an affordable alternative for Americans losing health coverage in 2026.
As direct primary care crosses 1.4 million members and approaches 1% of the U.S. population, the specialist referral gap is becoming the model's most urgent infrastructure problem.
A new Elation Health survey of 280 primary care physicians finds widespread financial anxiety, and independent doctors are already adopting DPC and membership models in response.
Rep. Marie Hopkins' HB7427 would let Rhode Island doctors charge insured patients extra fees alongside traditional care. The framing is primary care access. The mechanism is concierge medicine.
Northwell, University Hospitals, Endeavor Health, and Inova are aggressively expanding concierge medicine programs, validating the membership model but at dramatically higher price points than DPC.
Ultralight, formerly Vibrant Practice, raised $9.3 million to build an AI-native operating system for DPC and cash-pay practices. Former Surgeon General Vivek Murthy is among the investors.
Frontier Direct Care started in a borrowed desk in Harlingen in 2018. Now it operates 11 clinics across Texas, serves 100+ employers, and is expanding to Dallas.
Oklahoma's direct primary care physician count grew from a handful to nearly 150 in a decade, mirroring national DPC growth that now serves 1.4 million patients. Here's what's driving it.
Bronze plan enrollment surged 26% in 2026, and HSA-eligible plan selection jumped from 2% to 43% on HealthCare.gov. Combined with the new DPC-HSA compatibility rules, this creates millions of potential patients who can pay for DPC with tax-free dollars.
A new MedCity News analysis maps the four forces competing for control of primary care, and what that battle means for independent DPC physicians.
UberDoc launched a specialty referral program at Hint Summit 2026, giving DPC physicians access to 50+ specialties with upfront pricing and same-week availability.
PartnerMD's 2026 State of Primary Care Report surveyed 500+ patients and found an average experience score of 45/100, with 62% waiting a week or more and 80% worried about health issues slipping through the cracks.
Hint Summit 2026 kicks off April 8 in Nashville with CMS Deputy Administrator Chris Klomp and former Senate Majority Leader Bill Frist headlining, signaling federal attention on direct primary care.
Rhode Island's AG and House Speaker are sounding alarms about membership medicine draining primary care access. But the pricing they're describing is concierge, not DPC, and that distinction could define the movement's future.
Colorado HB 26-1096 would have let Medicaid recipients pay out of pocket for direct primary care. It passed the House 40-22, but a Senate committee voted 4-3 to postpone it indefinitely.
A Health Affairs study shows DPC and concierge practices nearly doubled from 2018 to 2023, but corporate-affiliated sites grew 576% while independent ownership dropped from 84% to 60%.
Seven Days profiles the growth of direct primary care in Vermont, featuring Blue Spruce Health's expansion to three locations and over 1,000 patients.
Mending, formerly Taro Health, launches Mending Access to connect DPC practices with TPAs and self-funded employers, already covering 100,000 lives across 12 states.
California and Oregon have enacted laws restricting private equity control over clinical decisions, and at least ten other states have passed or proposed notice and review requirements of their own. The regulatory backlash reinforces what DPC was built to protect: physician autonomy.
A physician's account of seeing 4-6 patients per hour with double bookings shows why the traditional primary care model is breaking, and why a growing number of doctors are choosing a different path.
VITL closed a $7.5M Series A led by SignalFire to build e-prescribing infrastructure for cash-pay clinics, including DPC practices. Here's what it signals about the market.
A new MedCity News analysis warns that DPC's rapid growth could trigger adverse selection in traditional insurance pools. Here's what the data actually shows and what it means for your practice.
Minnesota HF 1724 would establish direct primary care service agreements in state law for the first time, clarifying that DPC is not insurance.
Family Practice Management's March 2026 issue features a step-by-step guide for new graduates launching DPC practices, written by two physicians who did exactly that.
Match Day 2026 set records for primary care positions, but family medicine's declining fill rate signals a pipeline crisis that DPC's autonomy-first model is uniquely positioned to address.
Amazon is rolling out its Health AI agent on Amazon.com and the Amazon app, with pay-per-visit care starting at $29 for direct messages and AI-powered triage. What this means for direct primary care physicians.
Premise Health and Crossover Health completed their merger on March 12, 2026, creating a 900-center employer primary care network. Here's what it means for independent DPC practices.
Delaware's Senate Bill 1 would force insurers to invest more in primary care and cap hospital prices, exposing why the traditional system keeps failing and why DPC keeps growing.
A major Health Affairs study confirms DPC and concierge practices grew 83% from 2018 to 2023. Here's what that means for physicians considering the switch, and the access challenge the movement hasn't fully reckoned with.
The One Big Beautiful Bill made DPC memberships HSA-compatible starting January 2026. IRS Notice 2026-05 spells out the rules. Here's what every DPC physician needs to understand right now.
With over 7,200 employers now offering DPC benefits and HSA eligibility barriers falling in 2026, employer-aligned direct primary care is moving from niche experiment to structural shift.