Membership Models Comparison¶

Quick Summary: Most DPC practices use one of three simple approaches: (1) Individual vs. Family pricing with a family cap, (2) Age-based tiers, or (3) Annual membership + per-visit fee. Pick one and keep it simple—patients should understand your pricing in 30 seconds.

Table of Contents¶

• The Three Common Models
• What to Include in Membership
• Annual Payment Option
• Employer Contracts
• Models to Avoid
• Checklist

[!TIP] Keep It Simple: Survey data shows 74% of DPC practices use variable pricing (typically age-based), while 26% use flat per-member pricing. Either works—the key is choosing one approach and keeping it easy to explain.

The Three Common Models¶

[!NOTE] Practice examples below are for illustration only and may not reflect current pricing. Visit each practice's website for up-to-date information.

Model 1: Individual vs. Family Pricing¶

Simple two-tier approach with a family cap.

Example (Family of 4): - 2 adults + 2 children: $200/month (at family cap)

Why Practices Use This: - Simplest to explain and administer - Families know their maximum cost upfront - Encourages whole-family enrollment - No tracking age changes

Practices Using Model 1: - Ciampi Family Practice (South Portland, ME) — $60/month individual; family discounts available

Model 2: Age-Based Tiers¶

Pricing varies by age bracket, reflecting expected care utilization.

Example (Family of 4 with 2 adults age 42, 2 kids): - 2 adults @ $85 + 2 kids @ $35 = $240/month (or cap if lower)

Why Practices Use This: - More accessible for younger patients - Reflects actual utilization patterns - Attracts healthy young adults at lower entry price - Survey data: 66% of practices with variable pricing use age-based discounts

Practices Using Model 2: - NeuCare (Lawrence, KS) — Adults $79/mo, Children $59/mo - Holton Direct Care (Holton, KS) — $10-$100/month based on age - Stand Up Family Medicine (Marietta, GA) — Pediatric $69, Adult $129, Senior $149, Family $300

Model 3: Annual Membership + Per-Visit Fee¶

Lower annual fee with a flat charge per visit.

Example: - $1,250/year membership + $35/visit - Annual physical included; acute visits $35 each

Why Practices Use This: - Lower barrier to entry for patients - Patients pay proportionally to usage - Predictable base revenue plus visit income - Appeals to healthy patients who visit infrequently

Practices Using Model 3: - Osteopathic Center for Family Medicine (Hampden, ME) — $1,250/year + $35/visit; preventive visits free

National DPC Pricing Ranges (2024)¶

Source: AAFP DPC Data Brief, practice surveys

[!NOTE] HSA Update (2026): Starting January 1, 2026, DPC memberships up to $150/month individual ($300/month family) are HSA-eligible under new federal legislation. This may influence your pricing ceiling.

[!TIP] Research your market independently. Review publicly available pricing on practice websites to understand what patients in your area expect to pay. Useful directories include DPC Alliance and DPC Frontier Mapper. Your pricing should be based on your own costs, value, and business needs—not coordinated with other practices.

What to Include in Membership¶

Keep this simple too. Everything routine is included; specialized add-ons cost extra at transparent prices.

Included in Membership: - Unlimited office visits - Same-day or next-day appointments - Secure messaging with physician - Phone and video consultations - Annual wellness exam - Basic in-office procedures (ear lavage, wound care, suture removal) - Care coordination and referrals - Prescription management

Additional Cost (at wholesale + small markup): - Labs (passed through at cost or cost + 15-20%) - Procedures requiring supplies (joint injections, biopsies, IUD placement) - Dispensed medications - Vaccines (administration included, patient pays vaccine cost) - Imaging (coordinated at wholesale pricing)

Not Included: - Specialist visits - Hospital care - Emergency services

Annual Payment Option¶

Offer a discount for annual prepayment:

Example: - Monthly: $85/month ($1,020/year) - Annual: $918/year (10% discount)

Benefits: - Improved cash flow - Reduced payment processing fees - Patient commitment for full year - Attractive for HSA/FSA spending

Important: Have a clear refund policy for patients who move or have other qualifying life changes.

Employer Contracts¶

As your practice grows, employers may approach you about covering their employees.

Typical Employer Pricing: - Per Employee Per Month (PEPM): $100-$150 - Often 10-15% below individual rates due to volume - Dependents at additional cost

Keep it simple: - Same comprehensive coverage as individual members - Payroll deduction simplifies collection - Start with one small employer before scaling

See Pricing Your Practice for more on employer contracts.

Models to Avoid¶

[!WARNING] Complexity creates problems. These models sound good in theory but cause headaches in practice.

Multi-Tier Service Levels (Basic/Standard/Premium)¶

Problems: - Patients feel "nickel and dimed" - Creates perception of two-class care - Constant questions about "what's included in my tier" - Administrative nightmare tracking who gets what

Age-Bracketed Pricing (5+ age tiers)¶

Problems: - Patients "age into" higher prices (awkward conversations) - Complex to explain and remember - Minimal revenue benefit vs. simple adult/child split

Low Base + Fee-for-Everything¶

Problems: - Patients delay needed care to avoid costs - Undermines the "unlimited access" DPC appeal - Unpredictable revenue - Feels like traditional healthcare billing

The DPC Advantage is Simplicity: Patients are fleeing the complexity of insurance-based healthcare. Don't recreate that complexity in your pricing.

Checklist: Selecting Your Membership Model¶

• Calculate required revenue (see Pricing Your Practice)
• Choose your model: Individual/Family, Age-Based, or Annual + Per-Visit
• Set your rates based on local market research
• Determine family cap
• Define what's included vs. additional cost
• Decide on annual prepayment discount (typically 10%)
• Create simple one-page pricing sheet
• Draft membership agreement
• Practice your 30-second pricing explanation

Resources¶

• Pricing Your Practice - Calculate your specific pricing
• Membership Agreement Essentials - Document your model legally
• DPC Frontier Mapper - See other DPC practices and pricing

Next Steps¶

After selecting your model: 1. Pricing Your Practice - Run the numbers for your situation 2. Membership Agreement Essentials - Put it in writing