A new study by Jane M. Zhu, et al. in Health Affairs answers a frequent MGMA member question: How widespread are concierge and direct primary care (DPC) today?

The answer: more mainstream than ever. Using a linked national dataset, the authors tracked concierge/DPC sites and clinicians from 2018 to 2023, finding rapid growth alongside meaningful shifts in staffing and ownership.

For independent practice leaders, the numbers are the starting point. To answer the next question — how the industry is reacting, and what it may mean for workforce, access, business models, and ownership — we reviewed the coverage to see how it frames the broader discussion.

What’s in the report

The report’s headline findings are straightforward:

• Concierge/DPC practice sites grew 83.1% (1,658 in 2018 to 3,036 in 2023); clinicians working in them grew 78.4% (3,935 to 7,021).
• The clinician mix shifted: physicians declined as a share (67.3% to 59.7%) while advanced practice clinicians (APCs) increased (32.7% to 40.3%).
• Medicare participation was non-trivial, often read as evidence of concierge/hybrid models rather than “pure” cash-only DPC.
• Ownership shifted: independent ownership fell from about 84% to 60%, while corporate-affiliated practices grew sharply (576% growth in corporate affiliation).

What does it mean?

1. Concierge/DPC as an “escape valve”

Several pieces frame concierge/DPC growth as a clinician response to primary care pain points — administrative burden, payer friction, and less control over schedules and care delivery.

• Physicians Practice leans into this narrative, describing physicians moving to these models to “reclaim their autonomy,” and explaining how concierge and DPC differ financially (retainers plus insurance billing versus subscription outside insurance).
• Johns Hopkins Hub coverage (Note: the analysis had JHU coauthors) reinforces the clinician-experience angle, noting that both models can offer smaller panels and greater availability for enrolled patients.

This “escape valve” framing resonates with practice leaders competing for clinician retention. It also raises practical redesign questions: What would it take to approximate the experience (longer visits, less administrative burden) without abandoning broader payer participation? And which levers — team design, scheduling, payer mix, and technology — matter most to make that feasible at scale?