Momentum Matters: Keeping Direct Primary Care on Track in SC

For years, Palmetto Promise Institute has supported Direct Primary Care (DPC) as a key reform to improve healthcare access, affordability, and doctor-patient relationships in South Carolina. With the introduction of H. 3966 by Rep. Davis (R-Moncks Corner), the General Assembly has another opportunity to solidify legal protections for this innovative care model. 

This legislation comes at a pivotal time. Healthcare costs continue to rise, and many South Carolinians remain disconnected from consistent primary care. As of 2023, 17.5% of adults in South Carolina are deprived of a usual source of care, a greater proportion than the national average. Palmetto Promise has previously written about the dangers of this lack of continuity of care in our evolving world. Additionally, physicians face mounting administrative burdens, with one study finding they devote more than half of their days to electronic health records, a frustrating reality for those who attended medical school to pursue patient care not paperwork. DPC offers a practical, proven alternative, and South Carolina should act to continue supporting its growth. 

What is Direct Primary Care? 

Direct Primary Care is a healthcare arrangement in which patients (or their employers) pay their physicians directly through an affordable monthly, quarterly, or annual fee, rather than through insurance. This model typically includes unlimited access to routine care, same-day or next-day appointments, and direct communication between doctor and patient, without co-pays or billing surprises. 

By eliminating third-party billing and prioritizing the doctor-patient relationship, DPC alleviates cost burdens and enhances access to care. Physicians can spend more time with fewer patients, providing a better quality of care. 

Direct Primary Care dramatically reduces cost. When patients pay for services directly, rather than going through insurance, the price is often much lower. Routine labs, exams, and basic procedures typically come at a significantly reduced rate because there are fewer administrative costs, no billing departments, and no inflated pricing tied to insurance contracts. In many cases, paying in cash is both simpler and more affordable. Data from Mint Health’s 2024 cohort reveals the saving possible with direct payment: 

• Wart removal: $12 (DPC) vs. $610 (Traditional) → 98% less 
• Comprehensive metabolic panel: $3.31 vs. $48 → 93% less 
• TDAP vaccine: $48 vs. $82 → 41% less 
• Pap with labs: $69 vs. $143 → 52% less 

What Would H.3966 Do? 

H.3966 would clarify that DPC agreements are not insurance, a critical legal distinction that protects the model from inappropriate regulation. This could: 

• Encourage more physicians to open or join DPC practices 

• Preserve patient access to an affordable, transparent care option 

• Give small businesses more flexibility in providing employee health coverage 

• Help expand primary care access in rural and underserved areas 

This legal clarification is not unique. Over thirty states have passed laws related to direct primary care to encourage the growth of DPC practices. The outcomes of these laws speak for themselves. Among the eight states with the highest growth in DPC practices, six have enacted similar DPC laws. South Carolina should follow suit. 

Why Now? 

The need for accessible and affordable primary care has never been greater. With an expected shortage of 815 primary care providers in South Carolina by 2030, even large providers like Prisma Health have recognized demand and begun offering Direct Primary Care programs. Prisma’s recent expansion into DPC speaks to the model’s potential to manage costs and improve outcomes. 

For patients, especially those without employer-sponsored insurance, DPC offers an affordable entry point to reliable, preventive care, reducing unnecessary emergency room visits and avoiding more costly health crises. 

Conclusion 

Direct Primary Care provides unique benefits that South Carolina needs now more than ever. H. 3966 represents a strategic, no-cost way to support patient-centered care, reduce healthcare bureaucracy, and improve health outcomes for South Carolinians. By passing this legislation, lawmakers can remove a key regulatory barrier, allowing DPC to thrive. 

Momentum matters. The General Assembly has the chance to protect what’s working and empower what’s next through H.3966. We hope to see it receive a committee hearing early in the 2026 legislative session and pass both chambers with bipartisan support.