Direct Primary Care
Modern Healthcare, With Classic Style.

DPC is a membership-based model in which patients (or employers) pay a flat monthly fee directly to a primary care physician for comprehensive, unlimited access to primary care services—including visits, chronic disease management, preventive care, minor procedures, and same-day/telehealth access—without involving traditional insurance billing for those services.

Doctors in DPC typically see fewer patients per day, spend more time with each (often 30–60 minutes vs. the typical 15-minute Medicare visit), and eliminate massive administrative overhead (billing, prior authorizations, coding). This leads to better patient relationships, higher physician satisfaction, lower burnout, and measurable downstream savings through prevention and reduced utilization of expensive emergency rooms, specialists, and hospitalizations.

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Tecco, H. (2024). Direct primary care: Financial analysis and potential to reduce costs. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC11803065/

The U.S. has 61.2 million adults age 65 and older (as of 2024 Census data).

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Despite high reported access rates overall, approximately 4.1% (roughly 2.5 million seniors) lack a dedicated personal doctor or health care provider, according to the latest America's Health Rankings Senior Report (2023 data).

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This gap is worsening due to a severe primary care physician shortage, especially in geriatric care: the U.S. has only about 7,400 board-certified geriatricians for the entire senior population

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RSA projects a national shortage of over 70,000 full-time equivalent primary care physicians by 2038 (with rural and underserved areas hit hardest).

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U.S. Census Bureau data referenced via Administration for Community Living. (2024). Profile of older Americans: 2023. https://acl.gov/sites/default/files/Profile%20of%20OA/ACL_ProfileOlderAmericans2023_508.pdf (for population context supporting America's Health Rankings figures)

DPC offers predictable, transparent pricing that is competitive with (and often more efficient than) what the government currently pays for fragmented primary care services:

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• Typical DPC monthly subscription fee: $50–$150 per adult (most commonly $75–$100; children lower at $20–$75; family rates often available). This covers unlimited primary care—no copays, no billing surprises, and often includes basic labs, procedures, and virtual care.
  
  Assistant Secretary for Planning and Evaluation. (2024). Primary care spending in Medicare fee-for-service: An updated analysis. U.S. Department of Health and Human Services. https://aspe.hhs.gov/sites/default/files/documents/deb3e247637c0454b205ac0aa498faef/primary-care-metric-ib.pdf

The federal government should enact targeted tax forgiveness, credits, or other incentives for DPC practices and patients, building on recent progress (e.g., 2026 HSA eligibility for up to $150/month individual/$300 family DPC fees).

Specific ideas include:

• Tax credits or forgiveness for DPC providers serving Medicare/Medicaid patients (e.g., loan forgiveness, payroll tax relief, or income tax deductions tied to panel size in underserved areas).
   

• Expanded patient-side deductibility/credits beyond current HSA rules, making DPC fees fully tax-advantaged like other medical expenses.
   

• Pilot reimbursement or grant programs for DPC practices that demonstrate cost savings to Medicare/Medicaid (e.g., via reduced hospitalizations).
   

• Regulatory relief clarifying that DPC does not violate Medicare opt-out rules when paired appropriately with traditional coverage.

Meanwhile, over 100 million Americans of all ages lack a usual source of primary care, and the percentage of adults without one has risen 21% since 2012.

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DPC allows Doctors to establish their practice anywhere in America. This model allows Doctors to easily establish private practice models across rural America, or any community with a demand for additional healthcare services.

These incentives would be budget-neutral or savings-positive over time: DPC reduces administrative waste (practices spend ~40% less on billing), improves prevention, and cuts high-cost utilization that drives Medicare/Medicaid spending.

With 2.5+ million seniors already lacking a primary care home and shortages projected to balloon as baby boomers age, scaling DPC is a high-ROI way to strengthen the primary care foundation, ease physician burnout, and bend the cost curve on entitlement spending. Congress should act now—DPC isn’t just innovative; it’s a proven, patient-centered solution ready to scale with modest federal support.