Facing these price hikes, some people \u201care going with the catastrophic, higher-deductible plans and then coming in and saying, \u2018Hey, what do we do to help supplement that?\u2019\u201d Molaska told WPR\u2019s \u201cWisconsin Today<\/a>.\u201d<\/p>\n News with a little more humanity<\/p>\n WPR\u2019s \u201cWisconsin Today\u201d newsletter keeps you connected to the state you love without feeling overwhelmed. No paywall. No agenda. No corporate filter.<\/p>\n Molaska is offering a possible solution. Direct primary care, or DPC, is a health care business model where patients bypass insurance companies and pay a recurring membership fee directly to their doctor for unlimited access to primary care services. The fee covers regular doctor\u2019s appointments for basic illnesses and injuries along with preventative services like physicals and cancer screenings. It does not cover prescription medications, specialist care or hospitalizations.<\/p>\n At Molaska\u2019s practice, Dedicated Family Care, members pay between $45 and $110 per month based on their age. The list of available services<\/a> includes family planning and nutritional counseling, treatment for minor infections and injuries, in-office procedures like wart removals and chronic disease management for conditions like diabetes and arthritis. Molaska calls it \u201cwomb to tomb medicine.\u201d<\/p>\n Molaska opened the clinic in 2019 after experiencing burnout in the health care system and nearly leaving the profession. She says that the direct primary care model allows her to practice medicine the way she wants.\u00a0<\/p>\n \u201cI can have a clinic that serves underserved populations. I can focus on patient care,\u201d she said. \u201cI\u2019m no longer seeing 2,500 patients on my panel, I\u2019m seeing 600, but I would say that those 600 are getting much better care than when I was in the system.\u201d<\/p>\n Direct primary care grows in popularity<\/p>\n A small but growing number of doctors are moving to a direct primary care model. Between 2018 and 2023, the number of DPC and concierge practices grew by 83 percent nationwide, according to research<\/a> published in December. In Wisconsin, there are more than 100<\/a> DPC practices around the state, some with multiple clinics.<\/p>\n The demand is expected to increase after enhanced subsidies for the Affordable Care Act lapsed at the end of last year, increasing monthly premiums.<\/p>\n Last year, around 300,000 Wisconsin residents qualified for and used the enhanced subsidies, said Dan Sacks, associate professor of risk and insurance with the Wisconsin School of Business at the University of Wisconsin-Madison.\u00a0<\/p>\n \u201cIt\u2019s just going to be a lot harder for many people to get coverage,\u201d he said.<\/p>\n Direct primary care has traditionally been thought of as a \u201cboutique\u201d service that affluent patients might layer on top of existing health insurance to get better access to their doctor. Because DPC physicians tend to have a smaller pool of patients, members of their clinic can often get same-day or next-day appointments.<\/p>\n \u201cIn the past, it\u2019s mainly been appealing to high-income patients who can afford it and are willing to pay extra for that really quick turnaround,\u201d Sacks said.\u00a0<\/p>\n However, the clientele interested in this membership model of primary health care seems to be changing as health insurance becomes less affordable. At Molaska\u2019s practice in Fitchburg, 40 percent of the patients don\u2019t carry health insurance.<\/p>\n \u201cWe actually have a huge proportion of our patients who are completely uninsured because they\u2019re kind of falling through the cracks of making too much for BadgerCare here in Wisconsin, but not having health care through their employers,\u201d Molaska said.<\/p>\n With those patients, Molaska recommends pairing her direct primary care services with a catastrophic health plan<\/a> with a low monthly premium that will kick in for major expenses like hospitalizations after the deductible has been met, limiting the financial blow for unexpected emergencies. In 2026, these plans have annual deductibles<\/a> of $10,600 for individuals and $21,200 for families.<\/p>\n The costs can still add up, though, even with just one ER visit or surprise diagnosis. Sacks, the health economist, said that up to 95 percent of health care spending is on services that don\u2019t fall under the umbrella of primary care.<\/p>\n \u201cAlthough for a lot of people, their primary care provider is the face of their interaction with health care, only about 5 percent of health care spending is on primary care,\u201d he said. \u201cThe vast majority of it is on everything else \u2014 so that\u2019s drugs, but also specialist care, hospitalization, surgeries, cancer care. And, essentially, none of that would be covered with direct primary care.\u201d<\/p>\n Cost and health benefits of direct primary care<\/p>\n While there has been limited research on the cost benefits or health outcomes<\/a> of direct primary care at a systemic level, advocates argue that DPC can reduce overall spending on health care because people see their doctor instead of waiting until a problem is too urgent to ignore.\u00a0<\/p>\n About one-third of American adults say that in the past 12 months they have skipped or postponed getting health care they needed because of the cost, according to the latest polling<\/a> from KFF, a nonpartisan health policy organization. The number goes up to 75 percent for uninsured adults under age 65.<\/p>\n People are less likely to delay seeing a doctor when paying for direct primary care, said A.J. Moore, director of compliance and strategy at ViaroHealth in La Crosse.\u00a0<\/p>\n \u201cWith direct primary care memberships, once somebody is a member, that idea that you would delay or deny yourself care is kind of out of question,\u201d Moore said. \u201cIt\u2019s no longer part of the equation that you have that anxiety of the dollar sign or how long it\u2019s going to take to get in to see or talk to your provider.\u201d<\/p>\n Molaska has witnessed this at her practice.<\/p>\n \u201cA lot of my patients say that the little things can now stay little,\u201d she said. \u201cThey don\u2019t put off going to the doctor because of the worry of co-pays and coinsurance and deductibles.\u201d<\/p>\n Direct primary care sees a changing policy landscape<\/p>\n The policy and regulatory landscape for direct primary care has been evolving. The 2025 federal budget reconciliation legislation passed in July included a provision allowing people to use a health savings account to pay for direct primary care services.\u00a0<\/p>\n In Wisconsin, legislation that would exempt direct primary care practices from being regulated like insurance has been introduced multiple times with bipartisan support since 2017<\/a>. So far, it has failed to advance because of disagreements between Republicans and Democrats in the Legislature over discrimination provisions.\u00a0<\/p>\n![\"Three](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/01\/Ingrid-and-I-with-Maria-rotated.jpeg\")
Ingrid Ortiz, left, and Dr. Wendy Molaska, right, pose for a photo with a patient. \u201cWe helped diagnose her with cancer and get her the treatment needed,\u201d Molaska said. Photo courtesy of Wendy Molaska<\/p>\n![\"Five](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/01\/Pic-outreach-at-grocery-store.jpeg\")
Dr. Wendy Molaska and her associates from Dedicated Family Care at an outreach event at a local grocery store, where they did free blood pressure and glucose screenings. Photo courtesy of Wendy Molaska<\/p>\n![\"\"](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/01\/Viaro-Health-building-scaled.jpg\")
ViaroHealth\u2019s primary care clinic in La Crosse. Photo courtesy of ViaroHealth<\/p>\n