Direct Primary Care: A unique healthcare solution for employers

Among the various care delivery models that exist, direct primary care (DPC) is gaining traction among self-funded employers. DPC provides primary care services outside of a major medical insurance benefit and is not administered by a third party. In this white paper, we discuss the common key features of DPC offerings. We also present an actuarial perspective on claims for a midsized employer that implemented a DPC point solution in its self-funded medical benefit. We compared utilization and cost outcomes for about 900 members enrolled in DPC to the same outcomes for about 1,100 members not enrolled in DPC during a two-year period. A discussion of implications for employers follows, along with key considerations, such as program objectives, clinic placement, benefit design, operational effectiveness, and financial results.