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What it actually takes to move primary care under a fixed monthly fee: the numbers to pull, the plan design that has to change, the contract terms that matter, and the enrollment sequence that gets people using it.
At a glance
The 90-day path
Groups that skip the modeling phase almost always stall at contracting, because nobody can answer what the change is worth.
Pull two to three years of claims, plan documents, and census. The question you are answering is narrow: how much of your spend is primary care and avoidable acute care, and how much of it could move under a fixed monthly fee.
DPC only works financially when the wraparound plan is redesigned around it. Your broker or advisor rebuilds the medical plan assuming primary care is already covered, then prices the combination against renewal.
Employer DPC agreements are service contracts, not insurance products. They name the covered services, pricing, eligibility feed, reporting cadence, and exit terms. Clinics confirm panel capacity before signatures.
Enrollment succeeds or fails on communication. The groups with the highest activation run a live introduction with the physician, not a benefits PDF. Expect adoption to build over the first two quarters rather than on day one.
Where the money moves
A DPC fee is not cheaper than a primary care claim on paper. The case rests on what stops happening: employees who can text a physician the same day are less likely to end up in an emergency room on a Saturday, less likely to sit on a symptom until it becomes expensive, and less likely to get referred reflexively because the visit was seven minutes long.
Employers in DPC-paired structures have reported total healthcare cost reductions in the range of 15 to 30 percent, and independent studies of DPC populations have shown emergency room reductions of 40 to 60 percent. These are reported ranges, not commitments. Your own claims history is the only honest baseline, which is why phase one exists.
The second effect is variance. A fixed PEPM fee turns an unpredictable slice of spend into a known number, which for a 150-person company is often worth as much as the savings itself.
Enrollment
A network nobody uses still costs the full fee. Treat enrollment as a communication project with an owner and a calendar.
People sign up for a person. A 20-minute live session with the physician outperforms any packet, onsite for local teams and video for everyone else.
When should I use this instead of urgent care? Put that answer on a single card with the phone number and the messaging app. Nothing else.
Look at activation rate, visit volume, and time-to-appointment. If activation is low, the fix is usually communication cadence, not the contract.
Most employers see a workable case starting around 50 covered lives. Below that, a single practice contract is usually simpler than a network. Between 50 and 200 employees, a network arrangement lets you cover people in more than one location without negotiating each clinic separately.
Employer agreements generally run $75 to $150 per employee per month, depending on the market, the services included, and whether dependents are covered. That fee covers primary care access. It is paired with a wraparound or high-deductible plan for specialists, imaging, and hospitalization.
No. It replaces how primary care is delivered and paid for, not the insurance behind it. The usual structure is a DPC agreement plus a lower-premium plan that covers everything outside primary care. A benefits advisor should model the combination against your current plan before you commit.
Plan on 60 to 90 days from signed agreement to first visits for a group in this size range. That window covers eligibility file setup, clinic capacity confirmation, an employee communication cycle, and open enrollment timing.
Employees near a participating clinic use it in person. Everyone else uses secure messaging, phone, and video with an assigned physician. Groups spread across several states typically combine local clinics with virtual access rather than trying to put a clinic near every worker.
No responsible partner will guarantee a number. Published employer results commonly show reductions in emergency room use and total spend, but outcomes depend on your population, plan design, and utilization history. Treat every projection as a model, not a promise.
This guide is general information, not legal, tax, or benefits advice. Plan design, HSA eligibility, and DPC regulation vary by state. Review any arrangement with your own counsel and benefits advisor before implementation.
A 30-minute coverage review looks at your census, your locations, and what the network can actually reach before anyone talks pricing.
Request a Coverage ReviewWant the step-by-step onboarding sequence? See the employer enrollment workflow.
Physicians looking at the other side of this can read the employer contracting guide or browse the Independent DPC Network.
Methodology and sources
The 15 to 30 percent range is a model, not a study finding. It reflects what employers can see when a DPC layer replaces most primary care claims and the surrounding plan is redesigned around it: lower primary care claims, fewer downstream referrals, and reduced administrative load. The high end assumes a self-funded plan with an engaged population. The low end assumes a fully insured plan with limited redesign. Neither is a guarantee.
Independent research. The Society of Actuaries and Milliman studied a large DPC population against a matched traditional cohort and found adjusted claims costs roughly 12.6 percent lower for DPC members. That study covers claims cost alone and does not include plan-design savings, which is why our modeled range sits above it.
Utilization and satisfaction figures. The emergency and urgent care reduction range and the satisfaction figure come from practice-reported data inside our network plus published DPC and concierge utilization literature. They are reported ranges across practices, not a controlled study, and they vary widely by population.
Employer case data. We have not published an employer case study, because the groups we work with have not released their claims data. Named references and redacted results are shared during a coverage review under a mutual NDA. We would rather say that than publish a number we cannot show you the basis for.
Outcomes vary by employer population, plan design, funding model, and engagement. Nothing here is a guarantee of savings or of clinical results, and none of it is legal, tax, or medical advice.
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