Direct Primary Care

DPC: History and Growth

In the 1990s and early 2000s, some doctors began experimenting with “concierge medicine,” charging retainers for more personalized care. DPC evolved from that concept but with a focus on affordability and access – providing concierge-style service at a lower cost and without insurance billing. Early pioneers of DPC opened practices in the mid-2000s, and the model started to gain national attention by the 2010s.

Over the past decade, DPC has expanded rapidly across the United States. By mid-2023 there were over 2,100 DPC practices operating in 48 states, up from just a few hundred several years prior. Major medical organizations and even the Affordable Care Act have taken note: the ACA explicitly allows DPC memberships to be paired with a wraparound insurance plan for broader coverage, lending legitimacy to the model. More and more states (over 30 so far) have passed laws supportive of DPC.

This growth is driven by enthusiastic responses from both doctors and patients. Many primary care physicians have left traditional clinics to start or join DPC practices, citing the ability to practice medicine the “old-fashioned way.” Likewise, patients across the country have flocked to DPC for its promise of personalized, hassle-free care. Here in Nebraska, the number of DPC practices is still relatively small but climbing steadily. In fact, the past couple of years have seen something of a healthcare revolution in Nebraska: DPC clinics are popping up as an attractive alternative for patients frustrated with rushed visits and confusing bills. Industry observers predict DPC will become an essential part of the modern, cost-conscious healthcare landscape, both nationally and in our local community.

Benefits of Direct Primary Care

Direct Primary Care offers several big benefits compared to insurance-based primary care system. Importantly, this model aims to improve the doctor-patient relationship and overall healthcare experience, taking particular care not to showcase insurance in a negative light. (Insurance still has a role – primarily for expensive, unexpected events – while DPC optimizes everything else.) Here are some key benefits of DPC:

• Convenient, Timely Access to Your Doctor: DPC patients typically enjoy same-day or next-day appointments for urgent needs and much shorter wait times for visits  . Because DPC doctors limit their patient panel sizes dramatically, they can be available when you need them. In a traditional practice, a primary care doctor might be responsible for 2,000–2,500 patients, often making it hard to schedule timely visits. In contrast, DPC physicians usually care for only a few hundred patients In contrast, DPC physicians usually care for only a few hundred patients (often ~400-600) 13 . This smaller panel means you won’t be just a number – your doctor knows you and has time for you. Many DPC clinics also offer virtual visits or direct communication by phone, text, or email for quick questions and simple issues . For example, if you wake up with a concerning rash or your child spikes a fever after hours, you can often call or text your DPC provider directly to get guidance, avoiding the need to sit in an urgent care or ER. This level of access is a game-changer for busy families and working professionals.

• Longer and Unrushed Appointments: Have you ever felt rushed through a doctor’s appointment? DPC flips that script. DPC visits can be 30 minutes, 60 minutes, or as long as needed. With a DPC membership, you generally won’t feel hurried when you see your doctor. They have the time to listen to your concerns, answer questions, and provide enhanced involvement in your care decisions, which leads to a more thorough and personalized evaluation. As one local DPC physician put it, the traditional system was “mired and bogged down with rules and stipulations… [a DPC network] gives me the time to find out what a patient wants and discuss their options for better health.” This emphasis on quality time helps build a stronger doctor-patient relationship and often results in better understanding of your health needs.

• Personalized, Preventive Care (including Better Health Outcomes): Because DPC doctors can spend more time with patients and see them more promptly, they can focus on preventive care and managing chronic conditions proactively. Over time, this leads to healthier patients who require fewer high- cost interventions. Studies have begun to show improved outcomes with DPC. For example, a 2022 analysis found that DPC patients had significantly lower rates of emergency room visits and hospitalizations, thanks to better preventive care and access to their doctors. One DPC network reported that its members were 65% less likely to visit an ER and 35% less likely to be hospitalized compared to similar populations in traditional insurance plans  . Another pilot in Omaha found DPC patients spent 20% less on specialty care and 21% less on hospital costs than those using standard insurance in just the first year  . The idea is that when you can see your primary doctor early and often, small problems get addressed before they become big (and expensive) problems. Indeed, preventive services and chronic disease management are core to DPC memberships – routine checkups, wellness coaching, and managing conditions like diabetes or hypertension are all included, which can prevent complications down the road. Overall, a strong foundation of primary care is linked to better health outcomes and even lower overall healthcare costs per person, and DPC is designed to provide precisely that.

• Transparent, Affordable Pricing: A hallmark of Direct Primary Care is price transparency. You know exactly what you’re paying every month (e.g. $70, $99, or whatever the membership is), and what is included. There are no surprise bills for covered primary care services – no co-pays, no deductibles, no mysterious fees. Many DPC practices also list any additional fees up front, if they charge them at all. In fact, most routine in-office services are usually covered at no extra cost beyond the membership. For instance, our clinic’s DPC plan covers office visits, annual physicals, basic labs, and even procedures like stitches or EKGs for no additional charge. If there’s something not included, your doctor will tell you in advance and often can help you get it at an discounted cash rate. DPC practices commonly negotiate lower prices for things like blood tests, imaging (X-rays, MRIs), or specialist consultations for their members. The result: you might pay a fraction of the usual cost for these services. (For example, a lab test that might be $100 through insurance could be a fraction of that cost through a DPC-negotiated cash price – that kind of savings is not unusual.) This transparent approach simplifies your healthcare finances and puts you in control of your medical spending. Many people with high-deductible insurance plans find that DPC more than pays for itself through these savings, since they avoid high out-of-pocket costs for primary care. And for those with no insurance at all, DPC offers a way to access care at a known, reasonable cost. (Even nationally, typical DPC fees range around $100–$150 per month for an adult – often less than a monthly cell phone or cable bill – and around $50 for a child, varying by practice.).

• Less Red Tape and More Simplicity: Because insurance billing is removed from the equation in DPC, the experience is generally less bureaucratic for patients and doctors. There are no claim forms to fill out for your primary care visits and no fighting over coverage for a blood test or office procedure – it’s all covered by your membership. You won’t need prior authorizations for basic things or have to jump through hoops to get an appointment or referral. This streamlined approach means your doctor can focus on you, not on coding the visit or arguing with an insurance adjuster. One physician noted that DPC “removes the obstruction of health insurance from health care, allowing me to do for patients what they need, when they need it, at a reasonable cost.”  In short, DPC cuts out a lot of the hassle that both patients and doctors dislike in the traditional system. Many DPC members describe it as a refreshing return to when healthcare was simpler and more personal.

• A Relationship Built on Trust: All of the above benefits culminate in perhaps the most important aspect – a closer doctor-patient relationship. With DPC, you have a primary care provider who knows you and your story. They aren’t swamped with thousands of patients, so they remember your history, your medications, your goals, and even your family details. You can build a real relationship over time, which fosters trust. Patients often feel more comfortable contacting their DPC doctor with concerns, and doctors can tailor advice because they truly understand the patient. This kind of relationship can be invaluable, especially when navigating complex health decisions. Patients deserve care from providers who love what they do – and indeed, DPC doctors report greater job satisfaction and less burnout, which translates into warmer, more attentive care for you. DPC providers frequently say this model lets them “bring the care back to healthcare,” practicing medicine the way they feel is right. As a patient, having a doctor who is actively invested in your health and has the time to care makes a world of difference.

Direct Primary Care is designed to benefit patients and doctors by removing many of the barriers that have crept into modern medicine.

The bottom line is: By paying one reasonable fee for comprehensive primary care, you get peace of mind that most of your everyday health needs are covered – with a doctor who is available, caring, and working for you. At the same time, you’ll still want insurance for major medical events. DPC and insurance aren’t enemies; in fact, they pair nicely: you use DPC for the routine and preventive care (keeping you healthy and catching issues early), and insurance for the rare expensive stuff (hospitalizations, specialist surgeries, etc.). Many DPC members choose a high-deductible health plan or a health share plan as a backup, since DPC covers the day-to-day things that would otherwise come out-of-pocket. This strategy can save money compared to a traditional low- deductible insurance plan. The overall message is that you don’t have to hate on insurance to appreciate DPC – DPC simply reassigns insurance to its proper role (catastrophic coverage) and handles primary care in a more innovative, patient-centered way.