Direct Primary Care for Schools and Businesses

What direct primary care is (and is not)

Direct primary care (DPC) is a care model in which patients, or their employers, pay a flat periodic membership fee for routine primary care. The American Academy of Family Physicians describes DPC as a practice and payment model built around that membership relationship rather than insurance fee-for-service billing for those visits. See the AAFP Direct Primary Care overview.

DPC is not health insurance. It typically covers routine primary and preventive care under the membership. It does not replace major medical coverage for hospitals, specialists, surgery, emergencies, or many other costs. Schools and businesses that look at DPC usually keep or require separate qualifying coverage for employees.

Why schools look at direct primary care

School districts and private schools often want staff to get everyday care without long waits or confusing bills for simple visits. A DPC membership can give teachers and staff a clearer path to a primary care team for checkups, common illnesses, and ongoing follow-up that the membership includes.

For administrators, the appeal is usually predictability: a known membership cost for included primary care, rather than only discovering primary-care friction when someone cannot get an appointment. Whether a specific membership fits still depends on what it covers, which clinicians are available near your campuses, and how it works with the coverage your employees already have.

Why businesses look at direct primary care

Small and mid-size employers often ask about DPC because routine care access affects attendance, morale, and how usable a benefits package feels day to day. A flat membership fee can make the primary-care piece of the budget easier to plan than visit-by-visit surprise costs inside the membership.

DPC does not by itself solve hospital or specialist costs. Employers who explore it usually treat it as an access layer for everyday care, beside separate major medical or other qualifying coverage.

DPC vs. concierge medicine

Leaders comparing membership models often ask how DPC differs from concierge medicine. The short comparison below follows the educational framing used by the AAFP and similar medical organizations. It is not a ranking of any clinic.

Texas, California, South Carolina, and East Tennessee

We especially welcome questions from schools and businesses in these markets. We do not publish clinic directories or invent local practice counts. If DPC is on your radar, use the form on this page and we will help you think through the questions to ask.

Texas (Houston, Dallas, Austin, San Antonio)

Texas employers and school leaders often ask how to give staff clearer access to everyday primary care across large metro areas and growing suburbs. If your team is in Houston, Dallas–Fort Worth, Austin, San Antonio, or elsewhere in Texas, tell us what access looks like for your workforce today and what you want it to look like.

California (Los Angeles, San Diego, Orange County)

California schools and businesses frequently weigh membership primary care as a way to make routine visits more predictable for employees. Organizations in Los Angeles, San Diego, Orange County / Irvine, and other California markets can use the inquiry form to start a conversation about fit and next questions.

South Carolina (Greenville, Charleston, Columbia)

In South Carolina, employers and school administrators often want straightforward primary-care access for staff in Greenville, Charleston, Columbia, and surrounding communities. Share your locations and approximate headcount on the form so we can help you frame a practical comparison.

East Tennessee (Knoxville, Chattanooga, Tri-Cities)

East Tennessee schools and businesses in Knoxville, Chattanooga, and the Tri-Cities (including Johnson City and Kingsport) ask many of the same questions about everyday care access and membership models. Regional employers are welcome to reach out even if you are still early in research.

DPC and HSAs under the 2026 rules

Beginning for months after December 31, 2025 (that is, from January 1, 2026), IRS Notice 2026-05 and related legislation change how certain direct primary care service arrangements interact with Health Savings Accounts. In short (see also the IRS newsroom summary):

• A qualifying direct primary care service arrangement is not treated as a disqualifying health plan for HSA eligibility solely because of that arrangement, if aggregate monthly fees stay within the statutory caps.
• For 2026, those caps are $150 per month for an arrangement covering one individual and $300 per month when the arrangement covers more than one individual (inflation adjustments after 2026).
• HSA funds may be used tax-free to pay qualifying fixed periodic DPC fees that meet the notice's definitions.
• Notice 2026-05, Q-18: if the employer pays the DPC fee (including through a Section 125 salary reduction), that payment is generally not also reimbursable from an HSA.

Plan design still matters. Other coverage can affect HSA eligibility. Confirm details with a tax advisor. This section is education about DPC and HSA rules only.

Questions to ask before choosing a DPC arrangement

Before you sign anything, bring a short checklist to any practice or broker conversation:

• What primary care services are included in the membership fee, and what is billed separately?
• How soon can new members usually get a first visit, and how are same-day or next-day needs handled?
• Is phone, text, or portal messaging included? What about virtual visits?
• Which locations or clinicians would our employees actually use?
• How are dependents covered, and what does that cost?
• How does the practice coordinate with specialists, urgent care, or hospitals when needed?
• If we use Health Savings Accounts, how does this arrangement interact with the 2026 HSA rules?
• What happens if an employee leaves the organization mid-year?
• Can we review a sample membership agreement and a clear exclusions list before we commit?

For a longer explainer, see What Is Direct Primary Care? A Guide for Employers and Schools. Prefer to start on Start Here? Use the separate DPC inquiry block.

Frequently asked questions

What is direct primary care?

Direct primary care (DPC) is a membership model where patients or employers pay a flat periodic fee for routine primary care services, usually without billing insurance for those visits. It is not health insurance and does not replace major medical coverage.

Is DPC the same as health insurance?

No. DPC is a care-access membership for routine primary and preventive care. Hospitals, specialists, surgery, emergencies, and many other costs still need separate major medical or other qualifying coverage.

How can DPC help a school or business?

Many schools and employers look at DPC for more predictable primary-care access, fewer surprise visit bills for routine care inside the membership, and a clearer relationship with a primary care team. Fit still depends on local availability, what the membership covers, and how it sits beside existing coverage.

How is DPC different from concierge medicine?

Both can use membership fees, but DPC is generally built around a flat periodic fee for primary care without insurance billing for those visits. Concierge arrangements often involve a higher retainer and may still bill insurance for some services. Exact designs vary by practice; compare fee style, billing, panel size, and what is included.

Do employees still need major medical coverage with DPC?

Yes in almost every case. DPC does not replace major medical or catastrophic coverage for hospital, specialist, surgery, or emergency care. Employers and schools that explore DPC usually keep or require separate qualifying coverage.

What does a typical DPC membership include?

Memberships commonly emphasize ongoing primary and preventive care, longer or more accessible visits, and simpler pricing for included services. What is covered varies by practice. Ask for a written list of included services, exclusions, and how specialty or urgent needs are handled.

Is DPC useful for small businesses?

Many small employers look at DPC because the primary-care piece is a predictable membership fee rather than visit-by-visit surprise costs for included care. Whether it fits depends on local availability, membership scope, and how it sits beside existing coverage.

Is DPC useful for school districts and private schools?

School leaders often evaluate DPC for clearer staff access to everyday care and a known membership cost for included primary care. Districts and private schools should still confirm local options, dependent coverage rules, and how DPC sits beside existing employee coverage.

Where do you help organizations explore DPC?

We help schools and businesses in Texas, California, South Carolina, and East Tennessee (including Knoxville, Chattanooga, and the Tri-Cities) explore what direct primary care is and whether it may fit their teams. Use the form on this page to start.

Do the 2026 HSA rules change anything about DPC?

Beginning January 1, 2026, IRS Notice 2026-05 explains that certain direct primary care service arrangements within the monthly fee caps generally are not treated as a disqualifying health plan for HSA eligibility, and HSA funds may pay qualifying fees. Employer-paid fees are not also reimbursable from an HSA (Notice 2026-05, Q-18). This is general education, not tax advice.

How do we start a conversation about DPC?

Use the direct primary care inquiry form on this page. You can also schedule a DPC call or email [email protected] with the subject Direct primary care inquiry. This path is separate from SIMRP plan questions.