How DPC Cuts Small Business Healthcare Costs Without Cutting Care

If you own a small business in Southern Oregon, you have probably had the same conversation with your broker three years running: premiums are up again, and the only levers on the table are raising the deductible, shifting more cost to your team, or dropping a benefit people counted on.

None of those feel good. All of them ask your employees to absorb the increase.

There is a third option worth understanding. Direct primary care (DPC) adds a flat, predictable monthly membership for everyday primary care alongside your insurance plan not instead of it. It does not make your premium go away. What it can do is take the most-used, least-predictable slice of your team’s healthcare and move it into a number you can actually put on a budget line.

Here is an honest look at how the math works, where the value shows up, and what the published evidence does and does not support.

Start with What Health Insurance Actually Costs per Employee

Before comparing anything, get your real per-employee number.

Nationally, the average total health benefit cost reached $17,496 per employee in 2025 and is expected to exceed $18,500 per employee in 2026, a projected 6.7% increase and the steepest in fifteen years¹. For employer-sponsored coverage specifically, average annual premiums hit $9,325 for single coverage and $26,993 for family coverage in 2025.

Small businesses feel it hardest. Firms with 10–99 workers saw family premiums climb 26% over five years, and their employees pay a much larger share which is an average of $8,889 per year toward a family premium, versus $6,227 at larger firms². Looking ahead, small businesses with ACA-compliant plans face a median proposed premium increase of 11% for 2026, based on filings from 318 insurers³.

Sadly, some businesses have had to drop families and dependent coverage from workers in some cases.

That is the volatility problem in one line: a cost center that grows faster than your revenue, set by someone else, re-priced every renewal.

Everyday Primary Care Moves Outside the Insurance Claims Process

This is the structural piece most owners miss.

Under a traditional plan, a routine primary-care visit generates a claim. That claim runs through deductibles, copays, coinsurance, in-network rules, and an explanation of benefits that arrives weeks later. Neither you nor your employee knows the final number in advance.

Under DPC, the primary care included in the membership simply happens. Resolute Integrative Health does not bill insurance for clinic visits. The services covered by the membership occur outside the traditional fee-for-service billing process entirely, which is why there are no clinic copays and no surprise visit bills for included care.

That does not mean your insurance costs disappear, and it is not a promise about your year-end claims total. What it means is narrower and more useful: the portion of your healthcare spend that runs through the membership becomes a fixed, known figure from month one instead of a variable you discover in arrears.

Compare the Flat Membership Against the True Cost of a Routine Visit

A fair comparison has to include what a primary-care visit actually costs your business, not just the copay line.

Cost element	Traditional plan	DPC membership
Routine primary-care visit	Copay, deductible, or coinsurance; varies by plan	Included in membership
Cost predictability	Known after the claim processes	Known before the month starts
Follow-up questions	Often another billable visit	Direct phone, text, or message access
Wait for a new-patient appointment	Averages 31 days nationally, or several weeks in Oregon4	Same-day or next-day for urgent needs, when available
Employee time away from work	Travel, waiting room, rescheduling	Shorter, more direct contact
Employee-facing bills	EOBs, copays, balance surprises	No clinic copays for included care
Catastrophic coverage	Yes Tthis is what insurance is for	Not included; insurance still required

Employer DPC pricing at Resolute is quoted across your eligible workforce as a whole, not tied to any individual employee’s health status or expected utilization. You can review current membership options and pricing as a starting point, and confirm current employer rates directly with the clinic, since published pricing can change.

Count the Productivity Drag You are Already Paying For

Here is the cost nobody puts in the benefits spreadsheet: your employees’ time.

Each time someone accesses healthcare, they spend an average of 34 minutes traveling and 11 minutes waiting, equalling 45 minutes of pure overhead, which is more than half the time spent actually receiving care. Among working adults, that travel and waiting works out to around 90 minutes less work time, and researchers put the national economic cost at roughly $89 billion a year⁵.

Then add the wait to be seen at all. The average new-patient appointment wait time across major metro areas is now 31 days, up 19% since 2022⁴.

For a five-person crew, a month-long wait for a routine concern is not an abstraction. It is a problem that stays unresolved, gets worse, and eventually costs you a full day instead of an hour.

Resolute offers same-day or next-day scheduling for urgent concerns, subject to availability and clinical appropriateness, plus direct provider access by phone, text, or message. A quick message that resolves a question is a fundamentally cheaper transaction for your business than a half-day appointment three weeks out.

True emergencies still belong at an emergency department or 911. DPC is not a substitute for emergency care.

Be Honest About What the Evidence Shows

A Society of Actuaries study tracked a midsized employer that added a DPC option to its self-funded plan, comparing 912 DPC members with 1,074 who stayed in the PPO over two years, risk-adjusted for age, gender, and health status.

The results:

• Total allowed claims cost: 12.6% lower per member per month
• Emergency department visits: 40.5% lower
• Inpatient admissions: 19.9% lower
• Net employer cost: 1.3% higher, within a range of 7.8% higher to 5.2% lower between employers in the study.³

The 40.5% reduction in emergency department visits is the result employers should notice first. In this two-year comparison, DPC members also had 12.6% lower risk-adjusted allowed claims costs, even as their membership gave them access to primary care without a copay for included services. The employer’s estimated plan cost was 1.3% higher after adding the membership fee and other benefit changes, but that single figure does not capture the value of more accessible care or fewer ER visits. Lower claims could help a self-funded employer manage future healthcare costs, though this study did not establish what happened to premiums at later renewals.

The takeaway is that DPC can shift more care into a predictable membership while reducing use of expensive services; the employer’s total savings really depend on plan design and results over time.

Pair It with an ACA-Compliant Plan or Health Share

DPC is not insurance and should never replace it. Insurance exists to protect your business and your employees against large, unpredictable medical costs: hospitalization, surgery, imaging, specialty care, cancer treatment. DPC improves day-to-day access to a primary care relationship. It is a both/and structure.

Practically, that means your team keeps their ACA-compliant plan, a high-deductible plan (HDHP), or a health share for major needs, and uses the membership for everyday care. Insurance can still be used for outside labs, imaging, prescriptions, referrals, and specialists. For a fuller walkthrough of how the two fit together, see our overview of direct primary care for employers and our breakdown of what direct primary care costs and what it includes.

One note on funding: beginning January 1, 2026, the clinic’s FAQ states that Health Savings Accounts may be used for qualifying DPC membership payments, and some Flexible Spending Account plans may permit similar payments. Verify your specific situation with your plan administrator or tax advisor before making payroll or contribution decisions.

Recognize the Retention Value of a Benefit People Can Feel

Health coverage is the benefit your team is most attached to and least satisfied with. In one 2026 small-and-midsize-business survey, 58% of employees named health insurance as the benefit they would most hate to lose, yet rated how well it meets their needs at just 3.5 out of 5 — and 36% said better medical coverage would most increase their likelihood of staying⁶. Sadly better “health insurance” does not guarantee access.

That gap is your opportunity. A card in a wallet that requires a 31-day wait does not feel like a benefit. Being able to text a provider who knows you does.

Employers are noticing. Employer-funded memberships rose from 18% of active DPC memberships in 2017 to 60% in 2025, the first time employers have funded the majority⁴.

Worth noting: this model works best when participation is broad across your eligible team. Healthy, engaged participation is part of what keeps population-based employer pricing sustainable, which is also why access is offered to your workforce as a whole rather than selected individuals.

Is DPC the Right Move for Your Business?

DPC tends to fit best when:

• Your premiums are rising faster than your revenue and you want at least one line item you control.
• Your team is small enough that people matter individually. One employee out for a day is visible.
• Employees are skipping routine care because of cost, wait times, or hassle.
• You want to add something meaningful without restructuring your entire plan.

It is a weaker fit if you are looking to replace insurance, or if you need a guaranteed reduction in total claims spend. No one can honestly promise you that.

Talk with Resolute About Your Specific Numbers

Resolute Integrative Health is an integrative direct primary care clinic serving businesses and families in Rogue River, Grants Pass, Medford, and the surrounding Southern Oregon area.

Membership is built around longer appointments, direct provider access, same-day or next-day urgent scheduling when available, and predictable monthly primary-care costs, offered as DPC as an employee benefit for local employers.

The most useful next step is a real model, not a national average. Bring your head count, your current per-employee benefit cost, and your renewal date, and we will walk through what a flat membership would look like for your team alongside your existing plan.

Sources:

1. Mercer, health benefit cost per employee 2025–2026. https://www.mercer.com/en-us/about/newsroom/employers-and-workers-face-affordability-crunch-as-health-insurnace-cost-is-expected-to-exceed-18500-per-employee-in-2026/
2. KFF, small-business 2026 premium rate filings analysis. https://www.kff.org/health-costs/how-much-and-why-premiums-are-going-up-for-small-businesses-in-2026/
3. Society of Actuaries. “Direct Primary Care: Evaluating a New Model of Delivery and Financing.” Prepared by Milliman, May 2020. https://www.soa.org/globalassets/assets/files/resources/research-report/2020/direct-primary-care-eval-model.pdf
4. AMN Healthcare, 2025 Survey of Physician Appointment Wait Times. https://www.amnhealthcare.com/amn-insights/physician/blog/the-growing-challenges-with-physician-appointment-wait-times/
5. AJMC, travel and wait time economic cost. https://www.ajmc.com/view/travel-wait-times-for-healthcare-services-cost-89-billion-annually
6. Questco, 2026 SMB Employee Benefits and Retention Survey — https://blog.questco.net/what-do-employees-actually-want-from-their-benefits-in-2026