As healthcare costs continue to rise, employers are looking for strategies that improve care while managing long-term spending. One idea gaining traction is investing more in primary care, including models such as Direct Primary Care (DPC). But does it pay off? The answer is promising, but also nuanced.
A growing number of employers and health policy experts believe that when employees have strong access to primary care, they are more likely to receive preventive services, manage chronic conditions, avoid unnecessary emergency room, urgent care, and specialist visits, and stay healthier over time. These outcomes can lead to lower total spending.
This belief is one reason DPC continues to attract interest. The Direct Primary Care Coalition defines DPC as a model where patients or employers pay a flat monthly fee to a primary care provider in exchange for broad access to primary care services. Insurance is removed from primary care so the relationship is between the patient and the clinician. Can high value primary care exist in a traditional model? Absolutely. But, DPC removes a lot of barriers.
For employers, the question is simple. Does this approach lead to better outcomes or lower costs?
The most referenced actuarial evaluation of DPC is the independent study conducted by Milliman. They examined roughly 900 employees enrolled in a DPC model and compared them to about 1,100 employees in a traditional PPO plan over two years.
• DPC members used fewer high-cost services such as emergency rooms and urgent care visits.
• Increased access to primary care may lead to earlier interventions and better management of chronic conditions.
• In certain employer groups with older or higher-risk populations, downstream cost reductions offset or exceeded the additional primary care investment.
Milliman noted that adding DPC sometimes increases primary care spending because it allows more access to appointments. Total plan costs ranged from a small increase of 1.3 percent to a reduction of up to 5.2 percent depending on population characteristics and benefit design. That means DPC can produce savings, but only under the right conditions.
To bring the data and policy discussion to life, it helps to see how enhanced primary care works in practice. In this short video, “Monica McKitterick Explains How DPC is Transforming Primary Healthcare,” Monica provides a clear and personal explanation of why stronger primary care access matters.
Watch the video here: https://youtu.be/mVl_1cvIJJY?si=dg_8LWPE2Y2KjZrs
Monica offers several real examples that illustrate the human side of what studies like Milliman’s show in the numbers:
Patients are not just a claim file. Monica describes how longer visits and direct communication help people talk openly about what is going on. This often leads to earlier detection and more complete care.
With predictable access and no surprise costs, patients check in sooner and more often. Monica notes that this helps prevent small issues from becoming major ones. This aligns with Milliman’s finding of fewer emergency room visits.
Monica explains that removing insurance from primary care reduces confusion and friction. When people know how to reach their doctor and what a visit will cost, they are more likely to get help at the right time.
Monica highlights how the model allows clinicians to support chronic conditions, mental health needs, lifestyle changes, and follow-up care. These interventions can create long-term health improvements.
Her examples help illustrate why outcomes and cost patterns can shift when employees have consistent, relationship-based access to care.
I have seen real improvements in my health and meaningful cost savings through my DPC. Over time, she has taken on more of my care within the full scope of family medicine. I no longer see a gynecologist, urologist, or dermatologist, and I have not needed urgent care or the emergency department because access is so reliable.
By managing my health closely, she has helped me reduce the need for expensive medications and avoid procedures each year. This has saved both me and my employer money, and it has also saved me time. I spend far less of my life driving to appointments or waiting to be seen, and that time back has been invaluable to me and my employer.
The most honest answer is: it depends, but probably.
• A workforce has higher chronic disease burden
• Employees have had difficulty accessing care
• There is a history of avoidable urgent care or emergency room use
• The employer is self-funded and can measure downstream cost changes
• The benefit is paired with a thoughtful overall plan design
• Employees understand how and when to use the model
• The workforce is younger and already healthy
• There is little prior downstream utilization
• DPC membership costs outweigh potential cost avoidance
• The employer does not integrate primary care with the rest of the medical plan
Even when immediate cost savings are not guaranteed, employers often see improvements such as:
• Stronger provider relationships
• Better preventive care
• Easier chronic condition management
• Greater long-term stability in health trends
• Less absenteeism
• Higher employee satisfaction and retention
These benefits have real value for organizational culture and employee wellbeing.
Our role is to help employers evaluate whether enhanced primary care or DPC is the right fit for their organization. We prioritize transparency and data. Every workforce is different, and recommendations must reflect workforce demographics, claims history, and long-term goals.
For some employers, investing in primary care pays clear dividends. For others, the benefits show up through improved access, healthier employees, and a more stable benefits strategy.
If you want to explore whether this model could be a fit for your organization, we are happy to help.