I think the down votes are because "Direct Primary Care" doctors opt out of the insurance system. That's the point of the model. They collect monthly subscription fees instead dealing with your insurance company.

Granted, if they want to refer you to anyone else, your insurance may be involved, but not a few of them also have arrangements with those "health sharing ministries" where the patient cash pays for any procedure with the assistance of other people in the health share, which again saves enormous amounts of money by skipping the insurance system.