The State of DPC: What a New Report Reveals About Its Growth and Sustainability

The latest State of DPC report offers a data-driven view of a care model gaining momentum, while revealing the operational realities that will shape its next chapter.

Direct Primary Care (DPC) has long been discussed as an alternative to traditional fee-for-service medicine. The model’s appeal is straightforward: patients pay a recurring membership fee, and physicians deliver primary care without billing insurance for clinical services.

What has been less clear is what the DPC landscape looks like at scale. How large are these practices? Who is building them? What does a sustainable panel look like? And how much are patients paying for membership-based primary care?

The State of DPC report, published by the Direct Primary Care Alliance in July 2026, begins to answer those questions. Based on 465 physician responses collected in late 2024, the report provides one of the most detailed snapshots yet of a model that is expanding rapidly, but remains highly entrepreneurial and operationally lean.

Finding #1: DPC is growing, but much of the movement is still in build mode

The report cites a Hint Health estimate of more than 3,600 DPC practices nationwide as of the first quarter of 2025, with annual growth exceeding 19% since 2022. The survey itself received 465 unique responses, which the report says represents more than 13% of physician-owned DPC practices based on that estimate.

The survey also reveals who is driving this growth: women represent 67.3% of responding physicians, leading the shift toward independent, relationship-centered primary care.

The practice-age findings add important context to the growth story. Most respondents operate practices that are one to five years old, while a significant share are in their first year. A smaller group has been operating for more than a decade.

That distribution suggests DPC is not simply a mature model expanding through established organizations. New practices continue to open, and many physicians are still building the systems, patient relationships, and financial foundation required for sustainability.

The patient-panel data reinforces that point. Nearly 70% of respondents said their panel is not yet full. Across the full sample, 47.1% reported panels below 200 patients, 35.6% reported panels between 201 and 500, and 17.3% reported panels above 500.

These numbers should not be read as a limit on what DPC practices can achieve. Instead, they offer a more realistic view of the growth curve. A practice’s current panel size may reflect how recently it opened, how much time the physician devotes to clinical care, local demand, or the practice’s own definition of a sustainable panel.

Finding #2: Physician autonomy is a defining feature of the model

The survey’s ownership findings show how closely DPC is tied to physician independence. More than four in five respondents, 82.4%, reported full ownership of their practice. Another 8.9% reported owning 50% of their practice. Smaller shares were employed, minority owners, or contractors.

This ownership profile reflects more than a business structure. It points to a core reason physicians choose DPC: the ability to shape how care is delivered, how patients access the practice, and how the practice operates financially.

Medicare participation shows a similar emphasis on operating outside traditional billing requirements. The report found that 80.7% of respondents had opted out of Medicare entirely. Another 15.5% had opted in but were not seeing Medicare patients, while 3.9% remained in a model that billed Medicare for eligible patients.

The findings also highlight a challenge for physicians who are building a DPC practice while working elsewhere. Physicians who continue to see Medicare patients through other employment arrangements may not be able to opt out, which can force difficult choices about whether to exclude Medicare patients from the DPC practice or operate a more complicated hybrid model.

Finding #3: DPC practices are lean by design, not by accident

The typical DPC practice in the survey is small and focused. Nearly 90% of respondents, 89.3%, operated from a single location. Most were solo physician practices, and most did not employ physician assistants or nurse practitioners.

Support teams were also limited. About one-third of practices operated without support staff, while another third employed one staff member. The remaining practices had larger teams, but most still maintained a relatively small staffing footprint.

A lean structure can help preserve the direct, personal nature of DPC. It can also create pressure. In a small practice, the same people may be responsible for clinical documentation, patient communication, scheduling, membership enrollment, payment follow-up, reporting, and day-to-day business decisions.

That makes operational simplicity more than a convenience. It is part of the practice model. When administrative work is fragmented across multiple systems, the burden falls directly on physicians and small care teams. When core workflows are connected, practices have a better opportunity to protect time for patients while continuing to grow.

Finding #4: A “full” panel is not one standard number

The report offers a useful correction to the idea that every DPC physician should aim for a 600-patient panel. Among physicians who said their panels were full, panel sizes clustered most closely between 400 and 700 patients, which is broadly consistent with the commonly cited benchmark.

But the report also found full panels below 200 patients. Those practices may include physicians working part time, balancing other professional responsibilities, or spending significant time on leadership and administrative work.

The larger lesson is that panel capacity is not a universal target. A full panel is defined by a physician’s goals, availability, staffing model, and approach to care. For one practice, sustainability may mean a larger panel supported by a team. For another, it may mean a smaller panel that allows for longer visits, more frequent communication, or a particular clinical focus.

This flexibility is one of DPC’s strengths. It also means that practice leaders need visibility into their own capacity and economics, rather than relying on a single industry benchmark.

Finding #5: Membership pricing varies by geography and panel size

The survey found a national average membership price of $98.64 per member per month. That average masks meaningful variation by location and practice characteristics.

Urban practices reported an average monthly price of $110.00, compared with $99.78 for suburban practices and $81.56 for rural practices. By region, the West reported the highest average at $113.28 per month, followed by the Northeast at $110.44, the South at $98.38, and the Midwest at $80.36.

Panel size was also associated with pricing. Practices with panels below 200 reported an average monthly price of $105.93. Practices with panels between 201 and 500 reported $99.28, while practices with panels above 500 reported $77.74.

The report notes that this relationship may reflect several factors, including supply and demand, practice age, and whether older practices have raised prices over time. It should not be interpreted as a simple pricing formula. Instead, it shows that membership economics are shaped by the interaction of capacity, geography, and practice design.

The survey also found that age-based pricing remains the dominant tiering strategy, used by 76.4% of practices. Another 15.1% reported no tiering, while 8.5% used family-based pricing.

The next phase will require infrastructure that stays out of the way

The State of DPC findings point to a model with real momentum and a clear set of operational demands. Physicians are opening practices, taking ownership of their business models, and designing care around direct relationships with patients. Many are doing so with small teams, developing panels, and limited administrative capacity.

That combination creates an important opportunity for technology. The right tools should not make a DPC practice feel more like a large health system. They should help small teams manage the essential work of a growing practice without adding unnecessary complexity.

For DPC practices, that means bringing clinical documentation, patient communication, membership management, and payments into workflows that are easy to understand and maintain. It means supporting the physician’s way of working, rather than forcing the practice to adapt to disconnected systems. And it means using automation to reduce administrative weight while keeping clinicians in control of decisions that affect patient care.

As DPC continues to mature, the question will not be whether the model can attract physicians or patients. The early evidence suggests that it can. The more consequential question is whether practices can grow in a way that preserves the autonomy, access, and relationships that made the model compelling in the first place.

The report provides a valuable baseline for answering that question. It shows a movement that is expanding across the country, led largely by physician owners, and still defining what sustainable primary care looks like in practice.

Elation is committed to supporting primary care physicians as they build sustainable, relationship-centered practices. Learn more about Elation’s platform for Direct Primary Care.