DPC rewards family physicians for emphasizing patient care while reducing the overhead and negative incentives associated with fee-for-service, third-party-payer billing.
What is direct primary care?
The direct primary care payment 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 as well as 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.
Benefits of DPC for physicians and patients
DPC benefits patients by providing substantial savings and a greater degree of access to, and time with, physicians.
“If I hadn't discovered DPC, I might have left medicine altogether. Now I can't imagine practicing any other way.”
As DPC participation by family physicians continues to grow, the Academy remains committed to advocating for policies that improve the practice environment and make DPC accessible to even more patients.
For more than a decade, the AAFP worked with other stakeholders to enact statutory changes that allow individuals with health savings accounts (HSAs) to use those funds to pay for DPC arrangements. That new flexibility became law as part of the One Big Beautiful Bill Act (H.R. 1) in January 2026.
Physician burnout and practice satisfaction
94%
Nearly all respondents from a 2024 direct primary care study indicated they were satisfied with their overall practice, which is significantly higher than those not practicing in a DPC practice.
The Academy continues to work with federal policymakers to:
Allow employers to pay for DPC arrangements on behalf of their employees;
expand resources to support the viability and growth of independent primary care practices, including DPC practices;
clarify that state Medicaid agencies can pay for DPC arrangements for their beneficiaries and issue guidance on how to do so; and
amend existing Medicare opt-out policies so that family physicians can practice DPC while also providing needed care to Medicare beneficiaries in other community settings, such as skilled nursing facilities.
