The Direct Contracting Movement: Why Employers Are Taking Healthcare Into Their Own Hands

For most businesses, healthcare is one of the fastest-growing operating expenses—and one of the hardest to control.

Over the past five years, the average cost of employer-sponsored family health insurance has increased by 26%, with annual premiums now approaching $27,000 per family. Yet despite spending more than ever, many employers are seeing the opposite of what they hoped for: employees struggle to access timely primary care, chronic disease continues to rise, and productivity suffers.

Rather than continuing to absorb rising costs year after year, many employers are beginning to rethink how they purchase healthcare altogether. Instead of relying solely on traditional insurance networks, they're embracing direct contracting—building relationships directly with high-value healthcare providers who deliver transparent pricing, better access, and measurable value.

One of the most effective examples of this approach is Direct Primary Care (DPC).

Rather than replacing health insurance, DPC complements it by giving employees direct access to a dedicated primary care physician through a simple monthly membership. Employees receive timely care when they need it, allowing health concerns to be addressed before they become more complex—and more expensive.

For employers, Direct Primary Care may help:

Improve employee access to timely, relationship-based primary care.
Identify and treat health concerns earlier, before they require more intensive or costly care.
Reduce reliance on unnecessary emergency department and urgent care visits for conditions that can be managed in primary care.
Support preventive care and ongoing management of chronic conditions.
Provide a transparent, highly valued employee benefit that complements an existing health plan.
Maximize the value of employer-sponsored insurance by reserving it for specialty, hospital, and catastrophic care.

No single strategy can solve every challenge facing employer-sponsored healthcare. However, strengthening access to primary care is increasingly recognized as one of the highest-value investments employers can make. In fact, the 2025 KFF Employer Health Benefits Survey found that some employers are already contracting directly for primary care services in addition to their health plans—a sign that direct primary care and direct contracting are becoming part of mainstream employer benefit strategies.

This movement is gaining national momentum. Cost Plus Wellness, founded by Mark Cuban, is built on the same philosophy: connecting employers directly with healthcare providers through transparent pricing and direct contracts rather than unnecessary intermediaries. The platform brings together employers and high-value providers—including hospitals, surgery centers, imaging centers, specialists, pharmacies, and Direct Primary Care practices—to create a more transparent, patient-centered healthcare system.

If you'd like to learn more about this movement, I also recommend watching Shane Purcell's recent conversation with Mark Cuban. Their discussion explores why employers are increasingly embracing direct contracting and why strengthening primary care may be one of the smartest long-term investments a business can make.

The future of employer-sponsored healthcare isn't simply finding a cheaper insurance plan. It's building a healthcare strategy that delivers better access, better outcomes, and better value.