Practice Direct Care With Full Medicare Compliance and HSA Eligibility"

Maintain everything you love about DPC while eliminating its unnecessary legal and financial constraints

Direct Primary Care represents a powerful step toward physician independence and patient-centered care. But the standard DPC model comes with significant limitations that unnecessarily restrict your practice potential. Our approach preserves everything you value about direct care while eliminating the constraints that limit your growth and patient accessibility.

Why Traditional DPC Models Create Unnecessary Limitations

The DPC movement has made remarkable strides in returning healthcare to a direct physician-patient relationship, but several critical limitations hold back many DPC practices

Medicare Opt-Out Requirement

Traditional DPC models typically require physicians to opt out of Medicare completely. This not only limits your potential patient base but creates significant barriers for Medicare patients who want your care particularly problematic as the population ages.

HSA/FSA/HRA Funding Disqualification

Standard DPC membership fees are automatically disqualified from HSA/FSA/HRA funding because they’re structured as “membership fees” rather than payment for specific medical services. This means patients can’t use tax-advantaged funds, significantly reducing accessibility.

HSA Invalidation Risk for Patients

Even more concerning, patients with both a DPC membership and HSA account face potential IRS complications. Their entire HSA could potentially be invalidated, requiring tax payment on the full account balance if audited creating a major barrier for financially savvy patients.

Restrictive Pricing Models

The standard DPC pricing model ($50-150/month) creates both price ceiling expectations and revenue limitations while still requiring high patient volumes to achieve profitability. Many DPC physicians find themselves working just as hard for less compensation.

The Routine Exam Model: DPC Done Right

Our routine exam model maintains the philosophy and direct-care approach of DPC while eliminating unnecessary limitations

Medicare Compliance Without Opt-Out

Structure your practice to provide routine exam services that are explicitly excluded from Medicare coverage by federal statute. This allows you to charge cash fees to Medicare patients without opt-out requirements, significantly expanding your potential patient base.

HSA/FSA/HRA Qualification

By properly structuring your services as qualified medical expenses under IRC 213(d), your patients can use pre-tax dollars and employer-funded accounts to pay for your care. This dramatically expands accessibility beyond what traditional DPC can offer.

Appropriate Fee Valuation

Set fees that reflect the true value of your comprehensive care without being constrained by DPC market expectations. Our clients typically charge $1,800-$4,800 annually, creating sustainable economics with fewer patients and better work-life balance.

Maintain Control and Independence

Unlike corporate DPC platforms that may restrict your practice autonomy, our model ensures you retain 100% ownership and control of your practice with no ongoing revenue sharing or corporate interference.

Your Path from DPC to Routine Exam Model

Transitioning from a traditional DPC model to our routine exam approach is straightforward with our guidance

Assessment Phase
(Weeks 1-2)

Structuring Phase
(Weeks 3-5)

Implementation Phase
(Weeks 6-8)

Launch Phase
(Weeks 9-12)

Most DPC physicians can fully transition within 90 days with minimal disruption to patient care, experiencing revenue improvements within the first quarter after implementation.

DPC vs. Routine Exam Model: A Direct Comparison

Feature	Traditional DPC	Routine Exam Model
Medicare Status	Requires opt-out	No opt-out required
HSA/FSA Eligibility	Generally disqualified	Fully eligible when properly structured
Patient HSA Impact	May invalidate patient HSA	No negative HSA impact
Typical Annual Revenue	$300K-$500K	$750K-$1.2M+
Panel Size	600-800 patients	250-400 patients
Revenue Per Patient	$600-$1,200 annually	$1,800-$4,800 annually
Employer Funding	Generally not eligible	Eligible for employer funding
Insurance Integration	Typically abandoned entirely	Flexible – bill as desired
Corporate Control	Often tied to DPC platforms	100% independent ownership
Legal Foundation	Limited regulatory framework	Based on federal statutes (1965, 1996, 2006)

Common Questions from DPC Physicians

Can I transition my existing DPC patients to this model?

Yes. Most physicians successfully transition 70-90% of their existing DPC patients to the routine exam model. The enhanced benefits, particularly HSA/FSA eligibility, often make the new model more attractive despite potential fee adjustments.

Do I need to completely abandon my DPC branding?

No. You can maintain your core DPC identity and values while implementing the routine exam model’s structural advantages. Many physicians describe their practice as “Direct Primary Care with enhanced funding options” or similar messaging.

How do I explain the fee increase to patients?

We provide communication frameworks that emphasize the enhanced value (HSA/FSA eligibility, Medicare compliance) while maintaining your direct care philosophy. Many practices implement tiered options to accommodate different patient needs and budgets.

Can I still provide the same services as my DPC practice?

Absolutely. The routine exam model provides a compliant framework for delivering comprehensive primary care services. The primary difference is in how services are structured and documented, not in the actual care provided.

Do I have to terminate my DPC membership in my state association?

No. Many physicians maintain their DPC association memberships while implementing the routine exam model. These organizations provide valuable community and advocacy, even as your practice evolves beyond the traditional DPC framework.

Evolve Your DPC Practice to Its Full Potential

Direct Primary Care represented a critical first step away from the constraints of fee-for-service medicine. Now, the routine exam model offers the next evolution maintaining the direct care philosophy while eliminating unnecessary limitations.

Discover how to transform your DPC practice into a more profitable, compliant, and accessible model that truly fulfills your vision for patient-centered care without compromise.

From Traditional DPC to Thriving Routine Exam Practice

Dr. Michael Kingston, Former DPC Practitioner Nashville, Tennessee

Before

600 patients at $75/month ($450,000 annual revenue)
Medicare opt-out limiting potential patient base
Unable to accept HSA/FSA payments
High volume creating burnout
Limited time for complex cases

After

280 patients at $4,200 annually ($1,176,000 annual revenue)
Full Medicare compliance without opt-out
40% of patients using HSA/FSA funds
Reduced patient panel allowing comprehensive care
Waiting list of prospective patients
Complete ownership with no corporate platform fees

I was committed to the DPC philosophy but frustrated by its limitations. Jim’s approach allowed me to maintain everything I loved about direct care while eliminating the unnecessary constraints. I’m now earning more, working less, and providing better care than ever before. Most importantly, my services are actually more accessible to patients because of the HSA/FSA qualification and employer funding options that weren’t possible with traditional DPC.

During your consultation, we’ll discuss your specific DPC practice challenges and goals, analyze potential improvements, and outline a customized implementation plan that preserves everything you value about direct care while eliminating the limitations.

Contact Information:

Jim Eischen
Eischen DPSC LLC
2323 Locust Street
San Diego, CA 92106
619-919-5395
jim@eischenlawoffice.com

Practice Direct Care With Full Medicare Compliance and HSA Eligibility"

Maintain everything you love about DPC while eliminating its unnecessary legal and financial constraints

Why Traditional DPC Models Create Unnecessary Limitations

Medicare Opt-Out Requirement

HSA/FSA/HRA Funding Disqualification

HSA Invalidation Risk for Patients

Restrictive Pricing Models

The Routine Exam Model: DPC Done Right

Medicare Compliance Without Opt-Out

HSA/FSA/HRA Qualification

Appropriate Fee Valuation

Maintain Control and Independence

Your Path from DPC to Routine Exam Model

Assessment Phase (Weeks 1-2)

Structuring Phase (Weeks 3-5)

Implementation Phase (Weeks 6-8)

Launch Phase (Weeks 9-12)

DPC vs. Routine Exam Model: A Direct Comparison

Common Questions from DPC Physicians

Evolve Your DPC Practice to Its Full Potential

From Traditional DPC to Thriving Routine Exam Practice

Before

After

Executive/Corporate Health

Obesity & Nutrition Path

Lifestyle & Longevity (Routine Exam Model)

Specialty Care

Integrative Health

Functional/Integrative Medicine (fee for service menu)

Concierge Medicine Path

Direct Primary care/DPC

Assessment Phase
(Weeks 1-2)

Structuring Phase
(Weeks 3-5)

Implementation Phase
(Weeks 6-8)

Launch Phase
(Weeks 9-12)