As the year comes to a close, Direct Primary Care owners face a familiar challenge: balancing patient care with the financial realities of running a sustainable practice.
Before the holidays take over and tax season sneaks up, now is the ideal time to pause, review your numbers, and make intentional decisions that will shape the year ahead. In our recent webinar, we walked through the most important pricing, planning, and year-end financial considerations DPC owners should address to enter 2026 with clarity and confidence.
Below is a recap of the key takeaways.
1. Run Your Numbers With Clarity and Honesty
One of the biggest mistakes practice owners make is avoiding their financials or looking at them optimistically instead of realistically.
At a minimum, DPC owners should be reviewing:
- Profit & Loss statements
- Cash flow statements
- Key financial metrics on a monthly basis
If you’re not receiving these regularly, it’s time to ask why.
Beyond reviewing past performance, it’s critical to understand true capacity. How many patients can you realistically serve without burning out yourself or your team? This depends heavily on your ideal patient profile and the level of care required.
Knowing your capacity allows you to:
- Forecast growth responsibly
- Plan for additional providers or staff
- Avoid overextending yourself financially or operationally
2. Forecast Cash Flow for the Year Ahead
A cash flow forecast isn’t just an exercise, it’s a tool that should guide real decisions.
Whether you use a spreadsheet or dedicated software, a good forecast helps answer questions like:
- When will the practice actually be profitable?
- Can we afford to hire another provider?
- How much can the owner reasonably take home?
One common issue we see is practices building a forecast once and never revisiting it. Instead, it should be reviewed quarterly to compare projections against reality and course-correct as needed.
Cash flow forecasting gives you visibility and visibility reduces stress.
3. Pricing Increases Aren’t the Enemy of Good Care
Pricing is one of the most emotionally charged topics for DPC owners, but avoiding it can quietly undermine your practice.
If you’re not adjusting prices over time, rising costs will eventually squeeze your margins. Underpriced memberships often lead to:
- Seeing more patients than intended
- Burnout
- Reduced quality of care
When done thoughtfully, price increases are a tool for sustainability, not greed.
Key considerations when evaluating pricing:
- Rising operational costs
- Future investments (staff, technology, professional development)
- Regional affordability and income data
Most practices experience minimal churn when pricing changes are communicated clearly. In many cases, the increase results in higher net revenue even with small attrition.
4. Communicating Price Changes the Right Way
How you communicate pricing changes matters just as much as the change itself.
Best practices include:
- Providing 30–60 days’ notice
- Explaining the why behind the change
- Using clear, empathetic messaging
- Reinforcing the value and continuity of care patients receive
Many practices benefit from pairing written communication with a short video message from the physician, adding a personal touch and reinforcing trust.
5. Year-End Tax and Operational Planning Matters
From a tax perspective, many DPC practices operate on a cash basis, which allows for strategic timing of income and expenses.
Common year-end considerations include:
- Accelerating deductible expenses before year-end
- Delaying revenue when appropriate
- Ensuring payroll, bonuses, and benefits are properly recorded
- Preparing W-2s and 1099s early to avoid penalties
Operationally, year-end is also a great time to:
- Review systems and compliance
- Prepare inventory and staffing for Q1 demand
- Set goals and expectations with your team
6. Build a Practice That Supports Your Purpose
At the end of the day, financial planning isn’t about spreadsheets, it’s about sustainability.
When your practice is financially healthy, you gain:
- Peace of mind
- Time to focus on patient care
- Flexibility to serve your community more generously
A strong financial foundation allows you to do the work you set out to do, without constant stress or uncertainty.
Frequently Asked Questions
Q1: Do Direct Primary Care practices need to raise prices every year?
Not necessarily every year, but pricing should be reviewed regularly. As operating costs increase staffing, technology, supplies, and compliance static pricing can quietly erode margins. Many sustainable DPC practices implement modest, planned increases over time to keep the business healthy while maintaining patient trust.
Q2: How do DPC owners know if their pricing is too low?
Pricing may be too low if the practice is consistently cash-constrained, the owner is experiencing burnout from high patient volume, or there’s little room to invest in staff or technology. Reviewing gross margin, net profit margin, and patient capacity can quickly reveal whether pricing aligns with the value being delivered.
Q3: What financial reports should DPC owners review monthly?
At a minimum, DPC owners should review a Profit & Loss statement, a cash flow statement, and key financial metrics each month. These reports provide visibility into how the practice is performing, where money is being spent, and whether the business is on track to meet its financial goals.
Q4: Why is cash flow forecasting important for Direct Primary Care practices?
Cash flow forecasting helps DPC owners anticipate future revenue, expenses, and profitability instead of reacting to financial surprises. A well-maintained forecast supports better decisions around hiring, pricing, owner compensation, and growth and should be reviewed quarterly to stay accurate as conditions change.
Final Thought
2026 doesn’t have to feel overwhelming. With clarity around your numbers, a thoughtful pricing strategy, and intentional year-end planning, your DPC practice can enter the new year prepared, confident, and positioned for long-term success.
Book your strategy call today.