Growth In Number Of Practices And Clinicians Participating In Concierge And Direct Primary Care, 2018-23.

Area of Science:

• Healthcare Management
• Primary Care Models
• Health Services Research

Background:

• Growing clinician interest in alternative primary care models like concierge and direct primary care.
• These models offer smaller patient panels and increased clinical autonomy compared to traditional practices.

Purpose of the Study:

• To assess practice and workforce characteristics of concierge and direct primary care (DPC) practices.
• To analyze trends in ownership, clinician composition, and participation in Medicare within these models.

Main Methods:

• Utilized a national sample of concierge and DPC practices.
• Employed novel data linkages of public and proprietary information for analysis.
• Examined data from 2018 to 2023.

Main Results:

• Significant growth observed: 83.1% increase in practice sites and 78.4% in participating clinicians (2018-2023).
• Shift in clinician composition: physician share decreased from 67.3% to 59.7%, while advanced practice clinicians increased.
• Rise in corporate affiliation: independent ownership dropped from 84.0% to 59.7%, with a 576% growth in corporate-affiliated practices.
• Approximately 60% of clinicians in these practices participate in Medicare, indicating hybrid models.

Conclusions:

• Concierge and DPC models are experiencing substantial growth, indicating a significant shift in primary care.
• The evolving workforce and increasing corporate involvement raise important questions about clinical practice and patient access.
• Further research is needed to understand the long-term implications of these trends on healthcare delivery.