On July 29, the Primary Care Collaborative (PCC) hosted a webinar exploring how employers are developing innovative new approaches that expand access to whole-person primary care.
Panelists included Lowell Fernander (Rocket Companies), Bryce Heinbaugh (IEN Risk Management Consultants) and Lee Lewis (Health Transformation Alliance) with Laurel Pickering (Gateway Business Health Coalition) moderating.
Panelists discussed a variety of strategies for addressing growing challenges employers face in providing access to high-quality, whole-person primary care to their employees, from implementation of on-site clinical services to more effective usage of direct primary care. The panel also discussed the challenges faced in scaling those solutions and reiterated the importance of both behavioral health integration and consistent employer communication to drive engagement.
Fernander first emphasized that care deserts are not just a rural phenomenon. For example, residents in cities like Detroit face increasing barriers to primary care as older primary care physicians retire and systems underinvest in non-specialty care. Rocket Companies responded by creating an on-site clinic that integrates behavioral health, pharmacology, care management and more. And when COVID-19 began, the clinic became a critical resource in administering vaccines and supporting both employees and the broader community as other options vanished.
Heinbaugh then discussed direct primary care (DPC), a model that many employers now adopt. At $75–$100 per adult per month, DPC offers 24/7 access, same- or next-day appointments and a meaningful relationship with a clinician. This can eliminate the need for urgent care or ER visits. And for clinicians, the capped patient panels, minimal overhead and independence from fee-for-service (FFS) make this model financially sustainable and professionally fulfilling. A primary care clinician can earn a considerable salary while still maintaining autonomy.
Lewis soon explained how HTA built a scalable DPC network that meets the needs of large employers without requiring plan design changes, complex contracting or custom billing. Uptake among employees has been strong, although slow and steady. A single email each month triggers a 1–2% opt-in rate, as those currently seeking care pounce on the opportunity. Over time, one-third of employees engage with this network, but consistent communication is critical.
The conversation then turned to care integration. Fernander discussed how Rocket’s clinic includes on-site psychologists and a community psychiatrist, with clinical pharmacists collaborating across behavioral and physical health needs. The pharmacy offers nationwide delivery and embedded clinical support. Heinbaugh emphasized flexibility in plan design, tailoring services to workforce needs and using claims data to identify key drivers of cost and risk.
Transitioning the discussion toward data, Heinbaugh noted that while many DPC providers want to avoid FFS-style documentation, employers still need insight. Both he and Lewis described a compromise: capturing major encounters, tracking avoided ER visits and consult volumes, and using light-touch reporting systems. These mechanisms support population health tracking, risk stratification and compliance with HSA rules, while respecting clinician time and autonomy.
Finally, the panel touched on federal policy, especially the impact of HSAs. While recent legislation allows HSA funds to be used for DPC, Lewis warned that using retirement savings to fund basic care is a flawed workaround. HTA’s model classifies most DPC services as “safe harbor,” meaning employers cover them directly. Only significant sick care is paid from HSAs. Ultimately, employers are reclaiming primary care by removing barriers, centering patient needs and empowering clinicians.