In 2025, employers are again bracing for rising health benefit costs and growing pressure from employees who struggle to access primary care. At the same time, more organizations are testing on-site, near-site, and direct primary care clinics to regain control of spend and experience. For brokers, these clinic strategies are a practical way to rebuild trust and move from “renewal vendor” to strategic advisor.
In many organizations, the broker relationship still feels largely transactional: one intense renewal season each year, followed by long stretches of silence. When health plan premiums climb again, employers see the impact on their budgets while also knowing that broker commissions typically rise with premium volume. That dynamic can quietly undermine confidence in the relationship.
The cost pressures are real. Annual family premiums for employer-sponsored coverage climbed 7% to $23,968 in 2023, the biggest increase in a decade, according to the KFF Employer Health Benefits Survey1. Employers understand that this trend is driven by underlying utilization and unit costs, but they still ask whether their broker is doing enough to bend the curve versus simply helping them absorb the next increase.
Employees feel the squeeze as higher deductibles, growing out-of-pocket exposure, and difficulty accessing primary care translate into complaints that land on HR’s desk. When annual plan presentations amount to a choice among “least-bad” options, HR and finance leaders may conclude that their broker is bringing them products rather than a strategy.
In this environment, brokers who only show up to negotiate rates or move business between carriers risk being seen as intermediaries—necessary, but not strategic. Rebuilding trust requires visibly working on the structural drivers of cost and access, not just the symptoms.
Employer-sponsored clinics directly address two of the biggest sources of frustration for sponsors and employees: access to primary care and avoidable downstream costs. On-site and near-site clinics, as well as direct primary care (DPC) arrangements, make it easier for employees to get timely preventive and chronic care without navigating overburdened networks or long wait times.
These approaches are no longer limited to the largest employers. KFF’s reporting on workplace clinics describes how a 250-employee wholesaler opened its own clinic to address rising costs and an unhealthy workforce, and notes that an estimated 20% of employers with 200 to 999 workers and about 30% of larger employers that offer health insurance now provide on-site or near-site clinics, according to KFF survey data.2 The same coverage cites vendor data showing that roughly a quarter of one major clinic operator’s clients are firms with fewer than 500 employees, and those employers report lower overall costs and improved access when clinics are in place.2
Clinic-style models are also gaining traction within alternative primary care strategies. The Direct Primary Care Coalition defines DPC as a membership-based alternative payment model in which patients, employers, or health plans pay flat, simple periodic fees directly to primary care providers for unlimited access to primary and preventive services, and estimates more than 2,300 DPC practices in 48 states and Washington, D.C., serving over 300,000 patients today.3 That scale makes DPC a realistic option for employers looking to carve out and strengthen primary care access.
For CFOs and HR leaders, the appeal is straightforward: clinics and DPC can reduce emergency department use, improve chronic disease management, and make care more convenient, all of which can support productivity and retention. When a broker brings a credible clinic strategy that addresses these issues directly, it feels fundamentally different from another round of plan design tweaks.
When you champion an on-site clinic, shared near-site clinic, or DPC arrangement, you are explicitly addressing the upstream drivers of claims: unmanaged chronic disease, delayed primary care, preventable ER visits, and low engagement in preventive services. You are no longer just reconfiguring deductibles and networks; you are reshaping how care is delivered to that population.
This shift also changes how your role is perceived. Decent—an organization that partners with DPC practices and brokers—describes how brokers who integrate DPC into their strategies can position themselves as benefit advisors who advocate for employee health and wellness while managing healthcare costs, deepening client relationships in the process.4 When employers see you promoting solutions that may moderate premium growth—and therefore potentially affect commission-based revenue—they are more likely to view you as aligned with their outcomes, not just with premium volume.
Many HR and finance leaders have heard of employer clinics in passing but find the operational details daunting: site selection, staffing, integration with existing plans, data-sharing protocols, measurement, and communications. That complexity creates a clear opening for brokers who are willing to step into a true advisory role.
If you show up with a clinic playbook—clarity on different models (on-site, near-site, virtual-first plus local DPC), a view of financial scenarios, and vetted partners—you shift the conversation from “Which carrier should we choose?” to “What care model do we want for our workforce over the next three to five years?” That moves you from vendor to co-architect of the employer’s health and benefits strategy.
Trust ultimately comes from evidence. Case studies of employer clinics highlight the types of outcomes that resonate with finance leaders: lower ER and urgent care utilization, improved control of conditions like hypertension and diabetes, higher preventive screening rates, and employees who can see a provider within days instead of weeks.2
When you help design and implement a clinic program, you can tie your stewardship reports to concrete metrics—such as ER visits per 1,000 members, primary care visit rates, and cost trend compared with prior years. Being able to say, “We put this clinic in place, and here is what changed,” gives leadership a tangible reason to associate your advice with better results rather than just different plan designs.
A clinic is not a one-time placement; it requires ongoing governance. Utilization reports, employee feedback, integration with plan design, and evolving service offerings all need attention. That creates a natural rhythm of quarterly or semiannual strategy meetings focused on outcomes, not just premiums.
Over time, those sessions often expand beyond the clinic itself into related areas such as mental health access, musculoskeletal programs, maternity support, or pharmacy optimization. The more you are involved in those multi-year discussions, the more your client experiences you as part of the internal team rather than as an external vendor.
To credibly recommend clinics or DPC, your team needs a firm grasp of how these models work financially, clinically, and operationally. That includes understanding membership fee structures, how clinics coordinate with self-funded or high-deductible plans, data and reporting capabilities, and what success metrics matter most to employers.
The Spencer James Group, which focuses on recruiting in the benefits space, notes that advisors have to stay at the leading edge of insurance trends and emphasizes that with DPC “you’ll need to educate yourself first” because the model is still relatively new for many employers.5 That guidance translates directly to clinic strategies: invest time in vendor due diligence, site visits, and case study reviews so you can answer hard questions and frame clinics as one tool within a broader strategy, not a one-size-fits-all solution.
Clinic and DPC strategies aim to reduce avoidable utilization and, over time, moderate premium growth. If you are principally compensated via carrier commissions, that can raise understandable questions about your financial incentives. Addressing this head-on can itself be a trust-building move.
Some advisory firms are experimenting with fee-based or hybrid compensation structures that reward services and, in some cases, are tied to agreed outcome metrics. Even if you remain on traditional commission, explaining how and why you are willing to support strategies that might slow premium growth—and pointing to clinic and DPC programs as concrete examples—helps demonstrate that your primary objective is long-term employer value, not short-term revenue.
Once you have one or two clinic or DPC implementations in place, build a repeatable storytelling framework you can use across your book of business. A simple structure might include:
You can then share anonymized examples—such as a mid-sized employer that saw ER visits fall and employee access improve after opening a clinic, similar to the employer cases documented in KFF Health News coverage of workplace clinics.2 That sort of grounded example tends to resonate more with CFOs than abstract promises.
Employer clinics and DPC are powerful levers, but they are most effective when combined with other strategies: virtual primary care, high-performance or narrow networks, pharmacy carve-outs, musculoskeletal and metabolic programs, and targeted incentives for high-value care.
The DPC Coalition describes how DPC membership fees provide unlimited access to primary and preventive care, with more than 2,300 practices now operating nationwide.3 Decent’s guidance for brokers underscores that pairing DPC with thoughtful benefit design can improve access and outcomes while controlling costs.4 When you help clients integrate clinics and DPC into a cohesive, multi-pronged strategy, you reinforce your role as a true architect of their health benefits approach.
Repositioning yourself from vendor to advisor will not happen in a single renewal meeting. It happens as employers repeatedly see you bring forward ideas that tackle the structural drivers of cost and access rather than just reshuffling plan options. Employer clinics and DPC programs are a visible way to do that because they change how employees experience care and how claims show up in the financials.
Organizations such as the Direct Primary Care Coalition3, advisory firms like the Spencer James Group5, and partners such as Decent4 all highlight the same directional shift: brokers who embrace innovative primary care models deepen their relationships and are increasingly seen as trusted advisors rather than intermediaries.
For brokers who lead on clinics and DPC, the payoff is multi-dimensional: better outcomes for employees, more sustainable cost trends for employers, and stronger, longer-lasting client relationships. Over time, that is how you replace the “only calls at renewal” perception with a reputation as a key strategic partner in your clients’ business success.
Download the Broker Toolkit here to access resources on positioning yourself as a strategic benefits advisor, including a value-based partnership template and client-ready clinic and DPC case study outlines you can adapt for your own book of business.