Should Employers Pay 100% of DPC Membership?

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I want to tackle whether employers should pay the full DPC membership fee or only part of it. There are advantages and disadvantages for sure, but usually paying the full membership works best, allowing employees ot voluntarily select DPC or not. Let’s talk about it.

AI Summary:

  • Advantages of employers paying 100%:
    • Higher employee participation and use of the DPC service (fewer cost barriers).
    • Stronger recruiting and retention tool—positions it as a genuine, high-value benefit.
    • Greater likelihood employees will actually use primary care (no copays, deductibles, or out-of-pocket costs).
    • Simpler administration and billing (one invoice/payment instead of splitting costs or payroll deductions).
    • Potential tax advantages for both employer and employee (consult a CPA).
  • Disadvantages / concerns:
    • “Skin in the game” issue—some employees may undervalue or underuse a fully paid benefit.
    • Full financial commitment by the employer (e.g., $75/month × 100 employees = $7,500/month).
    • Some employees already have a primary care doctor they like and don’t want to switch.
    • Need a clear plan for what happens when employees leave, are terminated, or retire (can they continue the membership on their own?).
  • Recommended best approach (based on the speaker’s experience):
    • Employer pays 100% of the membership.
    • Enrollment is voluntary (don’t force employees to switch doctors).
    • Employees pay for spouses, kids, labs, meds, etc. (via payroll deduction or other arrangement).
    • Some self-funded larger employers may also choose to cover labs/meds because DPC pricing is often much cheaper than traditional options.
  • Bottom line: Paying 100% with voluntary enrollment generally works best for participation, retention, and simplicity while avoiding most of the drawbacks.

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.