Business & Finances

DPC pricing is both an art and a science. The membership fee must be high enough to sustain your practice with a reasonable panel size (400-800 patients) and low enough to be accessible to your target demographic.

National DPC pricing data (2025): - Adult individual: $50-150/month (median $85) - Children (under 18): $25-50/month (median $35) - Family of 4: $150-350/month (median $225) - Seniors (65+): $100-175/month (median $125) - Employer group rates: $50-125/per-employee-per-month

Pricing factors to consider: 1. Your local cost of living and median household income 2. Competitor pricing (other DPC practices in your market) 3. Your target panel size and revenue goal 4. Services included (more comprehensive = higher price justified) 5. Your overhead structure (solo vs. staff, lease costs, etc.)

The pricing formula: Target annual revenue / Target panel size / 12 = Monthly price per member. Example: $500,000 / 500 members / 12 = $83/month.

Tiered pricing is increasingly popular: - Basic tier ($60/mo): Office visits, phone/text access, basic labs - Standard tier ($85/mo): Everything in Basic + expanded labs, simple procedures, wholesale meds - Premium tier ($125/mo): Everything in Standard + home visits, after-hours access, annual executive physical

Most DPC practices offer a 10-15% discount for annual prepayment and family bundle discounts. Some also offer a "founding member" rate (locked-in lower price for early enrollees) as a launch incentive.

DPC startup costs are significantly lower than traditional practices because you eliminate billing staff, practice management software, clearinghouse subscriptions, and coding/compliance infrastructure. Many DPC physicians start in modest spaces (800-1,200 sq ft) with minimal equipment.

Typical DPC startup budget breakdown: - Lease and buildout: $15,000-40,000 (first/last/deposit + basic renovation) - Medical equipment: $8,000-20,000 (exam tables, diagnostic equipment, point-of-care labs) - EHR/technology: $2,000-5,000 (DPC-specific EHR, website, phones) - Legal and accounting: $3,000-8,000 (entity formation, DPC agreement, CPA setup) - Insurance: $5,000-12,000 (malpractice, general liability, cyber) - Marketing and branding: $3,000-10,000 (website, launch campaign, signage) - Working capital: $20,000-60,000 (6-12 months of personal expenses during ramp) - Miscellaneous: $5,000-10,000 (furniture, supplies, initial drug inventory)

Total range: $60,000-165,000 for a typical solo DPC launch.

Funding sources: - Personal savings (most common for DPC) - SBA 7(a) loans — physician practices have very high approval rates - Physician-specific lenders (Live Oak Bank, Provide, BankMD) - Home equity line of credit - Employer signing bonuses (sometimes negotiable if leaving a health system)

Ultra-lean DPC launch option: Some physicians have launched DPC practices for under $30,000 by subletting exam rooms from other practices, using house-call/mobile models, or starting as telehealth-first and adding a physical location after reaching 100+ members.

The DPC ramp-up follows a remarkably consistent pattern across practices: - Months 1-3: 20-60 members (friends, family, word-of-mouth, your existing patient following) - Months 4-6: 60-120 members (marketing starts working, community awareness builds) - Months 7-12: 120-250 members (referrals accelerate, reputation established) - Months 13-24: 250-500+ members (approaching target panel)

Cash flow timeline for a solo DPC practice (75 members/month at $85/month): - Month 1: Revenue $4,250, Expenses $8,000, Net: -$3,750 - Month 3: Revenue $10,625, Expenses $8,000, Net: +$2,625 - Month 6: Revenue $21,250, Expenses $9,000, Net: +$12,250 - Month 12: Revenue $42,500, Expenses $10,000, Net: +$32,500 - Month 18: Revenue $53,125, Expenses $11,000, Net: +$42,125

The breakeven point (where monthly revenue covers monthly expenses) typically occurs between months 3-6 for lean DPC practices. Full panel (and target income) is usually reached in 18-30 months.

Critical cash flow planning: 1. Have 6-12 months of personal living expenses saved BEFORE launch 2. Keep overhead as low as possible during ramp (no fancy office, minimal staff) 3. Consider starting as a side practice while still employed (weekends/evenings) to build initial panel 4. Employer contracts can dramatically accelerate your ramp — one 50-employee employer contract equals 4-6 months of individual enrollment growth

Beyond membership fees, DPC practices can generate additional revenue through:

1. Dispensed Medications: Purchase generic medications wholesale through DPC-friendly pharmacies (like Androgen, PricePharma, or Henry Schein) and dispense directly to patients at a modest markup. Many DPC practices buy metformin for $0.03/tablet and sell it for $0.10/tablet. Patients still save 80%+ vs. retail pharmacy prices. Annual revenue: $10,000-40,000/year for an active practice.

2. Wholesale Labs: Contract directly with reference labs (like Quest or Sonora Quest) for DPC-level pricing. A comprehensive metabolic panel might cost you $3-4 and you charge $10-15. Patients save dramatically vs. insurance pricing. Annual revenue: $15,000-50,000/year.

3. Procedures: Simple procedures (joint injections, skin biopsies, IUD insertions, etc.) can either be included in membership or charged as add-on services. Most DPC practices include basic procedures in membership and charge transparent cash prices for more complex ones.

4. Employer Contracts: Per-employee-per-month contracts with local employers. This is the highest-leverage revenue source — a single 100-employee contract at $75/PEPM adds $90,000/year in revenue.

5. Wellness Programs: Annual physicals, pre-employment screenings, DOT physicals for trucking companies, sports physicals for local schools. These can be offered at competitive cash rates.

6. Telehealth Revenue: After-hours telemedicine coverage for other practices, or telemedicine services for out-of-state patients (check licensing requirements).

Tax optimization is crucial for DPC physicians because you're self-employed and paying both sides of FICA (15.3% on the first $168,600 of earned income in 2025).

S-Corp Election: Once your practice nets more than $60,000-80,000/year, elect S-Corp status for your PLLC. Pay yourself a "reasonable salary" (typically $120,000-180,000 for a primary care physician) and take remaining profits as distributions. Distributions are NOT subject to FICA tax. Savings: $15,000-25,000/year for most DPC physicians at full panel.

Solo 401(k): As an S-Corp owner-employee, you can contribute up to $23,500/year as employee deferrals PLUS up to 25% of your W-2 salary as employer contributions. Total possible contribution: $69,000/year (2025 limits), plus $7,500 catch-up if over 50. This shelters significant income from current taxation.

Key deductions for DPC practices: - Home office deduction (if you do administrative work from home) - Vehicle mileage (house calls, hospital visits, conference travel) - CME and conference expenses (DPC Summit, Hint Summit, etc.) - Health insurance premiums (100% deductible for self-employed) - Equipment (Section 179 or bonus depreciation for first-year purchases) - Professional subscriptions and memberships

Quarterly estimated taxes: As a self-employed physician, you must pay quarterly estimated taxes (federal + state) to avoid underpayment penalties. Work with a CPA who understands physician practices — the penalty for underpayment can be 8%+ of the shortfall.

CPA recommendation: Find a CPA who specializes in medical practices, preferably one familiar with DPC. The Practice Math CPA group, Physicians Thrive, and WealthKeel are all physician-focused financial advisory firms.