Hiding in Plain Sight: Direct Primary Care Grew 837% — and Most People Still Haven't Heard of It

I talk about Direct Primary Care a lot these days.

I also talk to a lot of people who talk about it a lot — it's a rich, enthusiastic community of independent doctors and providers, plus the innovators and vendors who support independent practice. Which is exactly why it still surprises me when I meet someone who's never heard of it.

That happens every day. Often more than once a day.

"Have you heard of the model?" I'll ask. And they'll say, "Is it concierge?" Or, "Do you take insurance?"

No and no. And then I'm off, extolling the virtues.

Though the Line Is Getting Blurrier

I should be fair here, because my quick "no and no" is getting less accurate every year.

The traditional distinction was clean: concierge practices charge a membership fee and bill your insurance, typically at $2,000 to $3,000 a year or considerably more. DPC practices charge a lower monthly fee and don't bill insurance at all.

But the categories are bleeding into each other. Some concierge practices have dropped insurance entirely. And some DPC practices — particularly those at the higher end, or those built around longevity and executive health — have started marketing themselves as concierge, because that's the word patients recognize.

So the label matters less than the mechanics. When you're evaluating a practice, the questions worth asking are simple: What does it cost? Do they bill my insurance? How many patients does this doctor carry? Can I actually reach them?

The answers to those tell you far more than whichever word is on the door.

What I Tell Them

Access. A doctor at your fingertips — text, email, phone, with no call center standing between you and your physician. Same- and next-day appointments, instead of the wait that's become standard. AMN Healthcare's 2025 survey found the average wait for a new-patient appointment across six specialties in 15 major metro areas is now 31 days. That's up 19% since 2022 and 48% since 2004.

Continuity. One doctor who knows you. Not a rotating cast of substitutes and replacements as physicians burn out of medicine, leaving you to tell your story from scratch every time you finally get an appointment.

Time. Thirty, sixty, ninety-minute visits. None of the cramped, single-problem, five-to-seven-minute sprints that generate so much frustration in the conventional system.

We've Been Doing This Here for a While

And all of this is in Longmont, Colorado — home of the state's very first DPC practice.

Nextera Healthcare was founded here in 2009 by Dr. Clint Flanagan and his wife, Deirdre. It's still operating today as KerixHealth, with clinics across multiple states and a large affiliate network delivering DPC through employer partnerships around the country.

Nationally, the picture is striking. Hint Health's 2026 Direct Primary Care Trends Report — drawing on data from more than 2,700 clinicians and 1.4 million members — found that DPC membership grew 837% per capita between 2017 and 2025, far outpacing population growth. Clinician participation grew 555% per capita over the same period, and patient demand is still outrunning the supply of DPC physicians. There are now DPC practices in all 50 states, and Colorado remains one of the most concentrated markets in the country.

The report also found that the majority of active DPC memberships nationwide are now paid for by employers — and that employer-sponsored DPC pricing has stayed remarkably steady over the last five years, in sharp contrast to the volatility of traditional insurance.

That's growth from roughly 100 practices in 2009 to several thousand today.

And yet: with about 342 million people in this country, a few thousand practices is still a rounding error. So maybe I shouldn't be so shocked when someone hasn't heard of us.

Still — from 100 practices to a movement operating in every state in fifteen years, with no sign of slowing.

The Fair Criticisms

There are detractors, and some of their points are fair.

DPC is not insurance. A DPC membership does not cover your hospital stay, your surgery, your ER visit, or your specialist referral. (Though better primary care access is associated with improved control of chronic conditions and reduced need for the ER and hospital in the first place.)

But DPC has never marketed itself as a replacement for insurance.

Think about your car. You carry auto insurance for the big stuff — an accident, something unforeseen and expensive that would otherwise bankrupt you or leave you without a way to get to work. You don't file a claim to fill up the tank or replace your wiper fluid. Those are day-to-day needs you handle as they come, with a budget for them.

The same principle applies to your health. Yet the belief persists that insurance is the only mechanism for accessing a physician at all. As DPC practices keep demonstrating, that isn't true — and delivering care outside the insurance system turns out to be a better way to build and sustain a relationship with a doctor.

Why the Relationship Is the Whole Point

The doctor-patient relationship is the centerpiece of any collaborative approach to health — to preventing disease and to treating it.

This isn't sentiment. A 2023 study in the Journal of Public Economics found that losing a trusted primary care physician increases ER visits, hospitalizations, and mortality.

And in June 2026, a systematic review and meta-analysis published in Patient Education and Counseling examined 28 randomized controlled trials covering 18,046 patients. Led by researchers at Amsterdam University Medical Center alongside collaborators from Harvard Medical School, Boston Children's Hospital, Endicott College, and University College London, it found that when clinicians receive specific communication training, their patients experience measurably better physical health outcomes.

Here's the part that matters most: the researchers deliberately excluded patient satisfaction from their analysis. They looked only at hard medical data. The relationship didn't just make people feel better cared for — it made them measurably healthier.

As one of the study's authors put it, the effect for any single condition may be modest, but a good therapeutic relationship with your clinician accumulates clinical benefit across a lifetime.

So this isn't about satisfaction scores, and it isn't only about reducing physician burnout. Direct Primary Care is building toward something larger: improving the health of the country by putting the priority back where it belongs — on the collaboration that happens between a physician and a patient in an exam room, without an insurance company or corporate mandate driving toward billing and volume and muddying the water.

Come Talk to Me

If you're a patient who wants to learn more about DPC — or a business owner looking to improve the health and wellbeing of your employees — or a DPC-curious physician or APP wondering about a way out of the system — come talk to me. Or to one of my colleagues in this healthcare revolution:)

A future with better outcomes, driven by more meaningful relationships, is within reach. It starts with a phone call.

📞 720-856-4058 🔗 www.metronomemd.com/book