What’s Holding Employers Back from Adopting DPC?

Posted on by

As we slide into Labor Day weekend, let’s talk about what is really holding employers back from adopting DPC into their health plans. Is it money? Fear of the unknown? Or lack of knowledge of how a health plan would work with DPC? Let’s drill down into it so DPC docs and benefits advisors can open up some eyes.

AI Summary:

On the surface, employers often say the barrier is cost—they assume adding DPC means paying for their existing insurance plus a new DPC membership, which looks like extra spend (e.g., hundreds of thousands of dollars). Purcell argues that is usually not the real issue.

The deeper problems are:

  • Lack of understanding of how a health plan can be rebuilt around DPC (typically as a self-funded plan with DPC as the foundation).
  • Brokers/benefits advisors who default to renewing traditional “industrialized” plans (like Blue Cross) instead of explaining alternatives such as self-funding, transparent PBMs, and TPAs.
  • Fear of change: gutting and rebuilding the plan, employee confusion, and extra work.

He uses an example of a large county employer whose costs were rising. After a 45-minute explanation of DPC (keeping most care in-house, fewer ER/urgent-care visits, discounted labs and meds), their first reaction was “this will just cost more.” The real conversation then became changing the entire plan, not stacking DPC on top of the old one. Education over time reduced fear and showed potential long-term savings, even if the transition is painful at first.Takeaway for DPC docs and advisors: Surface objections about money often hide missing knowledge. Guide employers toward better-informed brokers and a redesigned, DPC-centered plan rather than treating DPC as an add-on. It takes courage and work, but the long-term benefits can be substantial. 

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.