Direct Primary Care: A Simpler Way for Small Businesses to Care for Their Teams

If you run a small business in Montana, you have probably had the moment. The benefits renewal letter shows up, you open it, and the number is bigger than it was last year. Again. You want to take care of the people who show up for you every day, but the math keeps getting harder.

You are not imagining it. A recent article from SHRM, the Society for Human Resource Management, lays out the numbers. Citing KFF's Employer Health Benefits Survey, SHRM reports that premiums for family coverage rose 52 percent between 2014 and 2024. A climb like that squeezes everyone: owners, managers, and the folks on the crew who feel it in their paychecks.

The same article points to something else worth sitting with. Health benefits still matter more to people than any other benefit an employer can offer. In SHRM's 2024 Employee Benefits Survey, 88 percent of employers said health benefits are important, ahead of every other category. So for most business owners the question is not whether to help their team stay healthy. It is how to do that in a way a small business can actually sustain.

A different way to think about primary care

One option getting more attention is direct primary care, often shortened to DPC. The idea is refreshingly simple. Instead of running everyday care through claims, networks, and copays, a business or a family pays a flat monthly membership directly to a clinic. In return, members typically get generous access to their care team: office visits, help managing ongoing health needs, and often the ability to reach their provider by phone or text when something comes up.

SHRM notes that the model has been growing steadily, with nearly 2,400 direct primary care practices now operating across the country. It is no longer a fringe experiment. It is a way of practicing medicine that puts the relationship between a person and their provider back at the center.

One thing we want to be clear about, because it matters: direct primary care is not health insurance, and it does not replace it. A membership covers the everyday care a clinic can provide. Most families and businesses pair it with other coverage for hospital stays, specialists, and the big unexpected events. SHRM describes exactly that pairing: employers contract directly with a primary care provider for day to day care, then add supplementary coverage for everything beyond it.

Why employers are giving it a serious look

Three things tend to draw business owners to this model.

First, predictability. A flat monthly amount per person is a number you can plan around, which is a rare thing in healthcare budgeting.

Second, access. When visits are already covered by the membership, people stop putting off the small stuff. A nagging cough gets checked before it becomes a week off work. That matters to any employer who has watched a busy season collide with a sick crew.

Third, people actually use it. SHRM shares the story of a St. Louis cleaning and restoration company that moved from a traditional plan to a direct care arrangement. What the company found was clearer pricing, better access, and employees who genuinely used the care available to them. The line item did not necessarily shrink, but the value of every dollar went up.

What this looks like here at home

Montana adds its own wrinkle to all of this. Our businesses tend to be small. Many of us do not have an HR department, or the time to become one. And care can be a long drive away, which makes a clinic that picks up the phone worth a great deal.

That is part of why the membership model fits the way our communities already work. It is a relationship with a clinic that knows your name, your family, and your work, the same way your mechanic and your banker do. Healthcare used to work that way in small towns. Direct primary care is, in many ways, a return to it.

Questions worth asking before you decide

SHRM offers a practical checklist for employers considering the model, and we think it is a good one for anyone in Montana to walk through:

• What is included? Clinics differ. Some cover visits and chronic care management. Others add labs and more. Know the scope before you compare costs.
• What sits alongside it? Plan for how specialist care, hospital care, and emergencies will be handled, since a membership does not cover those on its own.
• Who handles the details? Even simple models come with some administration. Know who is doing that work.
• Can you start small? SHRM suggests piloting a new approach and adjusting as you learn. You do not have to change everything at once.

The bottom line

Rising costs are not going away, and neither is the need to take good care of the people around us. Direct primary care is not the answer for every business or every family, but it is a real option, and it is built on something we understand well in Montana: a straightforward price and a relationship you can count on.

This article is general information, not medical or financial advice. Please talk with qualified professionals about your own situation.

Curious what direct primary care could look like for you or your team? Visit coremedhealth.com or email [email protected]. We are happy to talk it through, neighbor to neighbor.