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

Primary care clinicians have expressed growing interest in concierge and direct primary care practices, which often feature smaller patient panels and greater clinical autonomy compared with traditional primary care models. We assessed practice and workforce characteristics using a national sample of concierge and direct primary care practices identified through novel linkages of public and proprietary data. From 2018 to 2023, the number of direct primary care and concierge practice sites grew by 83.1 percent and the number of clinicians participating in them by 78.4 percent. The share of clinicians in concierge and direct primary care practices who were physicians declined from 67.3 percent to 59.7 percent, whereas the proportion of advanced practice clinicians increased. Approximately 60 percent of these clinicians participated in Medicare, suggesting concierge or hybrid practice. Independent ownership decreased from 84.0 percent to 59.7 percent, whereas corporate-affiliated practices grew by 576 percent during this period. The growth in these primary care models may offer substantive benefits to patients and clinicians, but it also raises broader questions about changing clinical practice and access to care.