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Direct Primary Care

DPC: An Alternative to Fee-for-Service

The Direct Primary Care Model

The direct primary care (DPC) model gives family physicians a meaningful alternative to fee-for-service insurance billing, typically by charging patients a monthly, quarterly, or annual fee (i.e., a retainer) that covers all or most primary care services including clinical, laboratory, and consultative services, and care coordination and comprehensive care management. Because some services are not covered by a retainer, DPC practices often suggest that patients acquire a high-deductible wraparound policy to cover emergencies.

Direct primary care benefits patients by providing substantial savings and a greater degree of access to, and time with, physicians.

The Academy’s Position on DPC

The American Academy of Family Physicians supports the physician and patient choice to, respectively, provide and receive health care in any ethical health care delivery system model, including the DPC practice setting.

What Members Need to Know

Direct primary care rewards family physicians for caring for the whole person while reducing the overhead and negative incentives associated with fee-for-service, third-party-payer billing. Other benefits to physicians include:

  • Decreased practice overhead
  • Fewer medical errors / less exposure to risk
  • Improved practice collections rates
  • More time with patients
  • Reduced patient volume
  • Zero insurance filing

Direct primary care and concierge care are not synonymous. In practices offering concierge care, the patient typically pays a high retainer fee in addition to insurance premiums and other plan obligations (e.g., copays, out-of-pocket expenditures), and the practice continues to bill the patient’s insurance carrier.

Get the answers to your questions about direct primary care with our DPC FAQ.

Learn More About the DPC Model

Family physicians interested in transitioning to a DPC model without external support can purchase the AAFP’s DPC Toolkit.

The DPC Toolkit will help you:

  • plan your DPC practice conversion;
  • create a sustainable DPC business plan for ongoing practice operations;
  • establish the appropriate membership fee structure for you and your patients;
  • address the financial aspects of running a DPC practice;
  • develop an effective marketing/outreach plan to recruit patients;
  • understand the regulations and legal implications that apply to the DPC model; and
  • identify appropriate service and/or technology providers to facilitate your DPC conversion.