A $700 Million Lesson
In late 2024, Forward Health—the VC-backed primary care startup that had raised over $700 million—announced it was shutting down. The company had operated tech-forward clinics in major cities, tried a self-serve AI "CarePod" kiosk model, and positioned itself as the future of primary care.
Then it ran out of runway.
If you're a physician considering Direct Primary Care, this story matters. Not because Forward was DPC—it wasn't, exactly—but because the media conflated the two, and the shutdown raised questions about whether membership-based primary care is viable.
The short answer: it's very viable. But there's a crucial distinction between what Forward was doing and what DPC practices do every day.
What Forward Was
Forward Health was a technology company that happened to deliver healthcare. It was backed by venture capital—investors who expected the kind of exponential growth you see in software, not the kind of steady, relationship-based growth that defines good medicine.
Forward's model:
The fundamental problem wasn't the membership concept. It was the burn rate. Forward spent tens of millions on technology development, urban real estate, and rapid expansion before proving the unit economics worked. When additional funding dried up, there was no path to profitability.
What DPC Is (And Isn't)
Direct Primary Care (DPC) is a physician-owned, relationship-first model where doctors charge patients a monthly membership fee for comprehensive primary care. Unlike Forward's tech-first approach, DPC prioritizes low overhead, small panels, and sustainable unit economics from day one.
Here's the comparison:
| Factor | Forward Health | Typical DPC Practice |
|---|---|---|
| Ownership | VC investors | Physician-owned |
| Startup capital | $700M+ raised | $50K–$150K |
| Technology focus | Proprietary hardware, AI kiosks | Off-the-shelf EHR, telehealth |
| Patient relationship | Rotating providers | Same doctor, always |
| Growth model | Scale fast, figure out profits later | Sustainable from 150+ patients |
| Monthly fee | $149 | $50–$150 |
| Clinic locations | Major cities, expensive real estate | Suburban/community offices |
| Staff model | Primarily NPs/PAs | Physician-led |
| Breakeven timeline | Never reached | 12–18 months typical |
The takeaway isn't complicated: DPC works because it's built on physician ownership, low overhead, and genuine patient relationships. Forward failed because it prioritized technology and scale over sustainable economics.
What DPC Physicians Should Take Away
1. The Model Isn't the Problem—The Execution Was
Forward's failure wasn't a referendum on membership-based primary care. Over 2,500 DPC practices across the country are profitable, growing, and delivering exceptional patient care. The membership model works. What doesn't work is spending $700 million to deliver something a solo physician can do with $100K and a genuine commitment to their patients.
2. Physician Ownership Matters
This is the fundamental difference. When a physician owns their practice, every decision is filtered through two questions: "Is this good for my patients?" and "Does the math work?" When investors own the practice, the questions become: "How fast can we grow?" and "What's the exit strategy?"
DPC practices don't need exit strategies. They need patients who trust their doctor.
3. Technology Is a Tool, Not a Product
Forward treated technology as the product—the AI diagnosis, the biometric sensors, the CarePods. DPC practices treat technology as a tool. An EHR for charting. Telehealth for convenience. A patient portal for communication. The product is the relationship between doctor and patient.
4. Investors May Come Calling
If you're a successful DPC physician, private equity and venture capital may approach you. The Forward shutdown doesn't change that—if anything, investors are now looking for DPC practices that have actually proven the model works.
Be cautious. The moment outside investors control your practice, the incentives shift. We've seen it happen, and it rarely ends with the physician feeling more autonomous.
The Media Got It Wrong
Several outlets reported Forward's closure with headlines suggesting that membership-based primary care doesn't work. That's like saying restaurants don't work because a specific venture-backed chain burned through its funding.
The reality:
Forward was an outlier, not a bellwether.
The Future of DPC Is Physician-Owned
If anything, Forward's shutdown strengthens the case for physician-owned DPC. It demonstrates that healthcare can't be scaled the same way software can. Patients don't want AI kiosks—they want a doctor who knows their name, answers their calls, and has time to listen.
That's what DPC delivers. And that's why it's growing.
Learn how to start a DPC practice, explore the DPC consulting hub, or see how the independent DPC network keeps physicians in control.