Direct Employer Contracts: Cuban’s CostPlusWellness

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Unless you totally avoid social media, my weekly video posts, or DPC News articles, you are keenly aware of the deep movement Mark Cuban has made recently into healthcare. He is speaking out more about direct care, direct contracting, transparent pricing, and the failure of our current healthcare system, especially on the drug pricing and PBM side. He started a discount generic mail-order pharmacy CostPlusDrugs a few years back and is now starting to make some of his own generic meds in a Texas factory. He’s challenging the big-boy chain pharmacies and PBMs, which are owned by insurance companies. 

Cuban’s latest market-busting endeavor is CostPlusWellness. On a recent podcast with me, he explained CostPlusWellness like this: employers have no idea what healthcare costs or how to find out. They cannot figure out health plans or pricing because they don’t know anything. “I was in the same boat,” he says. The prices are elusive. The answer he found is direct contracting. He had his team create direct contracts with any local hospitals, surgery centers, imaging centers, specialists, and lab facilities that wanted his support. They wanted to make deals with any quality providers of care using a direct model. No games. No codes. No co-pays or deductibles. “Give us your best price, and we will pay you.”  They did have one colossal condition for the contracts to be accepted, which is that the care providers must allow the contracts and prices to be listed on a public website. Guess what happened. Amazingly, they agreed.

Enter the website costpluswellness.com, where Cuban’s team posts every contract for their employees right on the web for all to see. Go look it up. Check the contracts for yourself. See the pricing. Interestingly, I can’t find any pure direct primary care clinics listed. Cuban told me (and he mentions it a lot in his talks) that his employees all have access to DPC, but there are none listed on this website. 

On the other hand, there is a third-party aggregator, Mending, listed on the site. These businesses evolved to connect employers to DPC clinics. Everyone should go and download their employer contract and read it. View how they pay for DPC services and how they pay themselves. Also, they mention how they handle data and what they require from DPC clinics. To say the least, this is very interesting and important contract language for DPC physicians to see. I’d check it out for sure. 

Kudos to Cuban and his team for creating this site and sharing it with the world. It’s worth employers, benefits advisors, and even DPC docs to look over this site and see how the sausage is made in direct contracts. I’d love to see a group of DPC physicians in a state or region posting a contract there. Maybe it’s coming soon? 

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About Shane Purcell, MD

Dr. Purcell is board certified family physician working in Anderson, SC. He received his medical degree from Mercer University in Macon, GA and completed family medicine residency at AnMed Health in Anderson, SC. After completing his residency, Dr. Purcell worked in a private group practice for 3 years before opening his own cash-only primary care clinic in 2005. As he built his cash-only clinic, he was also working part-time in a local urgent care facility. In 2008, he purchased a dormant medical clinic on the “wrong side of the tracks” and opened an urgent care and primary care clinic. After gaining his freedom from third-party captives, Dr. Purcell and a colleague formed the first direct primary care clinic in Anderson County in 2015. In 2019, he transitioned to full-time direct primary care and sold his urgent care. The direct primary care model has brought about a restoration of a relationship with patients broken by third-party middlemen. Now, he can offer more access and more of his time to patients. Dr. Purcell firmly believes that the direct primary care model is the last hope for health care in America. Dr. Purcell is an active member of several medical organizations including the DPC Alliance, Free Market Medical Association, and American Academy of Family Physicians. He is the former Chair of the Direct Primary Care Member Interest Group for the AAFP and a founding member of the DPC Alliance and the Carolina’s Free Market Medical Association. He was elected to the Advisory Committee for the DPC Alliance in the Fall of 2018 and completed his term in 2021. Dr. Purcell is the author of Magic, Pixie Dust, and Miracles: A Guide to Direct Primary Care and Employers which shares how to connect DPC with employers of all sizes. He has spoken about this topic and DPC in general at the DPC Summit, DPC Nuts and Bolts conference, Hint Summit, AAFP FMX, Carolina’s Free Market Medical Association, TedexFurman, and DPC Alliance Mastermind sessions. He continues to speak to residents and student groups about DPC as well.