237 How DPC is Growing in Pediatrics

DPC Is Growing in Pediatrics: Dr. Andrew Hertz on Zest’s Expansion, Survey Findings, and the Future of Care

The Pediatric Lounge welcomes returning guest Dr. Andrew Hertz, co-founder and president of the Zest Pediatric Network, to discuss the growth of direct pediatric care (DPC) and results from Zest’s national survey. Hertz reports Zest’s expansion from three Cleveland-area practices to 10 sites opening by summer, with 13 physicians across Ohio, Pennsylvania, and Florida, and describes using annual surveys because pediatric DPC data was previously lacking and the movement is growing about 25% yearly. Survey findings include that pediatric DPC is largely women-led (about 90%), mid-career, mostly solo practices; most charge $100–$175 per child per month with panels under 250 patients; about 48% are AAP members; and many report improved satisfaction and less moral injury. They discuss DPC benefits such as reduced office, urgent care, and ED visits, challenges with insurance and Medicaid capitation without CPT codes, AI’s operational promise and societal risks, and employer value focused more on employee satisfaction than pediatric ROI.

00:00 Welcome Back Dr Hertz

01:30 Zest Network Growth

02:50 Why Survey DPC

03:49 Who Joins DPC

05:06 Boards and MOC Debate

09:31 AAP Membership Questions

13:54 Why DPC Is Rising

18:22 AI vs EHR Efficiency

22:03 Insurance and Capitation

25:14 Hybrid Models and Access

29:08 Costs and Who Can Afford

32:45 Medicaid Capitation Hurdles

35:06 Data Without CPT Codes

36:24 Data Without Red Tape

37:07 ICD-10 and Simple EMRs

38:23 Holistic Prevention Coaching

41:32 Defining DPC Success

42:43 Net Promoter Score Explained

46:10 NPS for Behavior Change

49:19 Storytelling to Drive Adoption

55:53 AI in Pediatrics Promise and Peril

01:03:21 Beyond DPC Payment Models

01:06:15 Employers and Care Navigators

01:09:24 Closing Thoughts and Growth

01:11:31 Podcast Outro