Strouse suggested at the hearing that supporting direct primary care programs would be a good way for Congress to help small businesses provide better, more affordable health benefits.

"Primary care providers are your medical home," Strouse said.

If patients build strong relationships with direct primary care practice providers while getting routine care, the patients may then turn to the providers for help with getting steered toward high-quality providers of prescription drugs, imaging services and other health care products and services, Strouse said.

She asked House members at the hearing to support a House bill that would let patients use health savings account money to pay for direct primary care memberships.

Related: New House bill would expand HSAs to help workers pay for direct primary care

Strouse also suggested that hospitals in some markets could do more to encourage the expansion of direct primary care programs.

Other House bills would:

• Create a new Healthcare Freed Account that workers could use to pay direct primary care costs.
• Test the idea of letting veterans use direct primary care services.
• Let patients in Medicaid use direct primary care programs.

At early 2024, at the last BenefitsPRO Broker Expo, direct primary care was one of the ideas getting generating participant enthusiasm.

In September, the Heartland Institute, an independent research center that's popular with Republicans, gave the direct primary care concept more attention by putting a direct primary care proposal in a list of ideas for state lawmakers who want to make their states' health care markets work better.

Earlier versions of the new direct primary care bills have been introduced in previous congresses.

Traditionally, direct primary care bills have been introduced by Republicans but have often had Democratic co-sponsors.

The bills could have more chance of success this year because Republicans now control the House, the Senate and the White House, and some of the bills appear to have enough Democratic support to get through the Senate as ordinary bills.

Sources of friction: Direct primary care programs face some of the same kinds of criticism that many other new health care delivery ideas face. One is that high use of them could destabilize health insurers, hurt other types of medical practices or shut out poor people.

The programs also face concerns that poorly structured or poorly capitalized programs could promise too much care to too many people and end up leaving patients with sudden, unexpected gaps in access to care.

But the basic concept has bipartisan appeal, and the Primary Care Enhancement Act bill, the bill that would let HSA holders use the HSA cash to pay direct primary care dues, has a Republican House sponsor, two Republican co-sponsors and three Democratic co-sponsor.

The market: The list of direct primary care market players includes companies like Nextera Healthcare, One Medical, Plum Health and PeopleOne Health.

PeopleOne Health, for example, recently raised $32.3 million from a group of investors that included a Google affiliate to expand its direct primary care operations.

Companies like Marathon Health market direct primary care practice access through relationships with traditional health plans. In New Jersey, for example, a State Health Benefits Program website managed by Horizon Blue Cross Blue Shield of New Jersey offers an information page that plan participants can use to sign up for access to a Marathon Health direct primary care doctor.

Other companies, like Centivo, are creating somewhat different primary care models that put the primary care providers on top inside a health plan structure. Centivo announced last week that it's now working with Premise Health to set up health plan that will rely heavily on medical offices on employer worksites and near employer worksites.

The involvement of direct primary care and advanced primary care programs in state employee and union plans may help them in Washington this year, because health policy specialists at some of the organizations that typically side with Democrats on health policy issues may have access to direct or advanced primary care programs through their own benefit plans.

If the health policy specialists like their own direct or advanced primary care providers, they might be open to proposals that support the direct and advanced primary care programs.