Direct Primary Care

According to the American Academy of Family Physicians, the direct primary care (DPC) model gives family physicians a meaningful alternative to fee-for-service (FFS) 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 and to be compliant with Affordable Care Act mandates.

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

DPC rewards family physicians for caring for the whole person while reducing the overhead and negative incentives associated with FFS, 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.

DPC 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.

The AAFP 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.

AAFP Resources

Additional Information & Resources