The claim that Direct Primary Care only works in affluent city neighborhoods does not survive contact with the map. This guide walks through rural, urban, suburban and employer sponsored DPC, answers the equity question honestly, and explains the 2026 HSA change that lets patients pay membership fees with pre tax dollars.

Direct Primary Care replaces insurance billing for routine care with a flat monthly membership, usually $50 to $150. Panels run 400 to 800 patients instead of 2,000 or more, visits run 30 to 60 minutes, and many practices open for under $50,000. Dr. Maryal Concepcion walks through the math, the myths, and who the model actually fits.

Dr. Erika Bliss was in the room when the term Direct Primary Care was written into Washington state law. She co-founded Qliance in 2007, ran it as CEO through seven clinics and a Medicaid contract, and watched it close in 2017. She rebuilt as a solo doctor in Seattle with one medical assistant and about 400 patients.