Target Audience

Healthcare professionals.

Description

The United States (U.S.) The healthcare system is a complex network of stakeholders, including clinicians, patients, support staff, and insurance companies. Over the years, many flaws in this system have significantly impacted how patients receive the primary care they need. Some of these factors include access to care, co-pay expenses, and insurance barriers. Insurance companies decide what should be covered for each patient without knowing their medical history or understanding the ever-changing medical knowledge that clinicians continually apply in practice. More specifically, when patients schedule an appointment with their Primary Care Provider (PCP), they are often limited to discussing only one chief complaint, since that is what their insurance will cover. These factors have also impacted clinicians in various ways. Limited appointment times, managing massive patient panels, excessive administrative duties, and overall stress levels have caused PCP burnout to significantly increase.    

PCPs are at the forefront of diagnosing and managing chronic conditions. Current research has found that having access to a PCP is vital to patient health outcomes, especially since 90% of the $3.5 trillion spent on U.S. health care funds is on chronic disease management. Recently, new delivery models have been founded to improve primary care delivery, such as concierge medicine and Direct Primary Care (DPC). The concierge model charges a ‘retainer fee’ averaging $135 a month or $1,500 to $1,700 annually in exchange for specific primary care services. Concierge practices accept insurance and state-funded plans. 

The DPC model of medicine is an emerging primary care model in which patients enroll in a monthly membership plan and make direct monthly payments to a DPC practice for specific primary care needs without billing insurance companies. The average cost for an adult membership in 2024 was $50 to $100 per month, and for children, $20 to $49 per month. DPC is a model of medicine that aims to offer preventive care, longer, more personalized visit times, and help reduce the burden of administrative duties that clinicians face. The question this literature review addresses is how the DPC model can address systemic flaws in insurance-based primary care, such as insurance barriers, clinician burnout, and patient frustration, while evaluating its viability as a sustainable solution for primary care delivery in the future. The audience for this literature review includes patients receiving primary care services, employers, and current and future primary care clinicians. 

Learning Objectives

1. Describe the Direct Primary Care (DPC) model of medicine.
2. Differentiate DPC from traditional insurance-based primary care.
3. Explain how DPC impacts clinician burnout, patient access, and cost of care.
4. Evaluate the financial, ethical, and practical implications of adopting DPC as a standard of care.
5. Discuss strategies to educate clinicians, patients, and employers about DPC. 
6. Discuss the limitations of DPC.
7. Discuss the future of DPC.

Speaker

Anna Veltien
Physician Assistant Student, Des Moines University Medicine and Health Sciences

Faculty Advisor

Kenna Willey, PA-C
Assistant Professor, Master of Science in Physician Assistant Studies Program, Des Moines University Medicine and Health Sciences

Ms. Willey has reviewed the slides for completeness, clinical accuracy, and recommended action. 

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Recording date: March 13, 2026
Date of original release: March 13, 2026
Most recent review/update: March 13, 2026
Termination date: March 12, 2029