Week 15: Direct Primary Care – A Conversation with Dr. Eric Bricker

The article below is based on the information Dr. Bricker shared during our conversation. 

For years, employers, advisors, and employees have all felt the same frustration: the health care system seems out of ideas. Premiums continue to rise, access continues to tighten, and traditional primary care has been stretched so thin that most people no longer have an ongoing relationship with a doctor at all.

Direct Primary Care (DPC) offers a different path — one that is growing quickly among employers looking for better care, better engagement, and lower long-term costs. To help unpack the model, we turned to one of the country’s most trusted voices on health care delivery and cost management: Dr. Eric Bricker, internist, educator, entrepreneur, and board member at Frontier Direct Care. Dr. Bricker’s work in health system navigation, including his leadership at Compass Professional Health Services and his Healthcare Z platform, has helped millions of people better understand how the system works — and how it can work better.

Below is a narrative summary of the key insights Dr. Bricker shared about direct primary care: what it is, how it works, who it helps, and why employers are increasingly embracing it.

Direct Primary Care replaces traditional fee-for-service primary care with a flat monthly subscription, typically paid by the individual or the employer. Instead of billing insurance for every visit, every lab review, and every question, DPC provides unlimited access to a primary care provider — in person, by phone, or by telemedicine — for one predictable monthly fee.

There are no claims, no billing codes, and no surprise invoices. When an employer funds the subscription, the employee’s out-of-pocket cost for primary care is usually zero.

What truly distinguishes DPC from concierge medicine — a point often misunderstood — is this complete removal of insurance billing. Concierge practices may charge a membership fee, but they still bill your insurance for every visit. DPC does not. That difference fundamentally changes the provider’s incentives and the patient’s experience.

Traditional primary care often runs on 15-minute appointments, half of which is documentation. Dr. Bricker notes that the average patient receives seven and a half minutes of face-to-face time with a physician — far too little to build a relationship or manage chronic conditions effectively.

DPC flips that model. Because physicians are no longer paid per visit, they are free to spend 30, 45, even 60 minutes with a patient. They also manage smaller patient panels — roughly 800 patients instead of the 2,500–3,500 seen in traditional primary care. As a result:

• Same-day or next-day appointments are common

• Telemedicine is used appropriately instead of as a billing opportunity

• Patients don’t delay care because they fear the cost

• Providers have time to understand a patient’s life, family, job, and environment

And that relationship matters. As Dr. Bricker puts it: “Nothing effectively happens unless there is trust — and trust doesn’t happen without a relationship.”

Primary care in America has been stretched so thin that the relationship aspect has been largely lost. DPC intentionally restores it.

While many people assume direct primary care is a luxury product, Dr. Bricker emphasizes that the model is especially effective for blue- and gray-collar workforces — the very people least likely to have an established relationship with a primary care physician.

Many employees use urgent care or the ER as their primary touchpoint with the health system. When these employees suddenly gain zero-cost, immediate access to a doctor who actually knows them, health engagement changes dramatically.

The model works best when:

• Employees are geographically concentrated

• The group is self-funded or level-funded

• Leadership is willing to champion the program

• Communication reaches both employees and spouses

DPC is not meant to replace the health plan’s network. Instead, it reduces unnecessary use of the network — particularly high-dollar services.

The financial value of DPC does not come from replacing what employers previously spent on primary care. It comes from reducing the biggest cost drivers: ER visits, hospitalizations, and unnecessary specialist use.

Across DPC practices, employers often see:

• 50–75% reductions in ER utilization

• 20–40% reductions in hospitalizations

• 20–30% reductions in specialist visits

These are the same areas responsible for the majority of high-cost claimants — the “20% of members” who drive “80% of costs.”

Traditional care management tries to help these individuals after costs have already materialized. DPC prevents many of those episodes in the first place.

Most employers work through their benefits broker or consultant to identify and vet a DPC provider. In some markets, there are multiple options; in others, the market is still developing. Quality varies, so employers should get to know the actual clinicians, not just the brand name.

The most important factor in a successful rollout is communication. Employees need to hear from HR, leadership, and often their front-line managers that this is a real, employer-funded benefit — not a scam, not a replacement for insurance, and not a disruption to their specialist care.

Once enrolled, employees typically receive a proactive outreach from their DPC provider, helping establish the relationship from day one.

Cost Structure

DPC fees generally range from $50 to $100 per member per month, depending on geography and provider. Many practices now tie part of their fees to actual savings — a structure that increases employer confidence and aligns the financial incentives.

Employers often fear backlash if employees must change doctors. But surveys show that the majority of employees have not seen a primary care doctor in the last two years — even in white-collar settings. With primary care access so limited, the concern rarely matches reality.

Still, if an employee is actively engaged with a provider they like, the health plan network remains available. DPC does not eliminate or replace the network; it simply becomes the front door to care, guiding patients appropriately and reducing unnecessary use of specialists and hospitals.

Direct Primary Care is not a silver bullet — but it is a thoughtful, practical solution in a moment when employers feel boxed in by rising costs and declining access. It restores the primary care relationship, improves the patient experience, and meaningfully reduces avoidable claims.

We want to thank Dr. Eric Bricker for sharing his time and expertise. His insights highlight why so many employers, especially in today’s cost-challenged environment, are exploring direct primary care as a fresh, practical solution. We hope this overview encourages readers to dig deeper into DPC and consider how it might fit into a long-term strategy for healthier employees and more sustainable plans.

You can find Dr. Bricker on the internet, on Amazon, and all over social media:

• Web: www.AHealthcareZ.com

• LinkedIn: https://www.linkedin.com/in/ericbrickermd/

• Twitter: @DrEricB

• YouTube: AHealthcareZ

• Book: Healthcare Money Campfire Stories (Available on Amazon)