Cora Mattie spent fifteen years inside the traditional healthcare system before reaching a breaking point. One night, after seeing fifty patients in a ten-hour urgent care shift, she drove home knowing she still had hours of charting ahead. In conversation with Mehul Agarwal, Founder of HealthCompiler, Cora reflected on how that moment led her to Direct Primary Care (DPC), and what she has learned building a practice from the ground up. "I was approaching my 40s, and I was like, this cannot be what I'm doing for the second half of my life," she recalls. A colleague had introduced her to the idea of DPC, and the two initially talked about starting a practice together. They eventually decided to go their separate ways — her colleague headed south, and Cora opened Balanced Healthcare in the north Denver area in June of 2020, just as the pandemic was upending daily life. "That was a very interesting first year," she says.
From Clinician to Practice Leader
Despite launching into a pandemic, the practice found its footing and has grown steadily since opening. Cora recently brought on a third practitioner — a PA with 21 years of experience — and has increasingly shifted her own focus from clinical work toward business development and DPC advocacy in Colorado.
What changed for Cora in the second and third years was a growing awareness of the bigger structural problems in healthcare. She had solved the first problem she set out to solve — patient-centered care and provider work-life balance — on a small scale. But she realized that because so many Americans have their health insurance controlled by their employers, nothing will change if those employers don't know DPC exists.
"If we don't reach those employers and let them know that there is an alternative to what has become an abysmal status quo, they are going to keep signing on the dotted line and nothing's going to change," she says.
Expanding Access Through Collaboration
Cora is passionate about DPC's potential to make a broader impact among employers. Having seen firsthand how quickly the model resonates with CFOs and CEOs once they understand it, she believes the biggest challenge is simply awareness.
"The more that we can take the people who are a little loud about this and move them into rooms where they can be talking to more people, especially CFOs and CEOs, the more impact we can make and sooner," she says. With double-digit insurance increases expected again, she believes the tipping point is near. "People have to know DPC exists if we want to move the needle and have an impact."
Navigating the Complexity Between Primary Care and Catastrophic Coverage
One of the challenges Cora sees across the DPC landscape is what she calls the middle space — the specialty services, surgeries, and higher-acuity care that sit between primary care and catastrophic coverage. Controlling costs in that layer remains one of the harder problems for DPC practices working with employer groups.
"Employers want to see the data, period. There's just no way around that," she says.
Cora sees self-funded models and emerging direct-care specialty providers as part of the solution, and she believes data will be foundational to making it all work. She points to the growing ecosystem of tools and platforms that can help DPC practices present meaningful outcomes to employers.
The Value Patients Experience
Cora has watched the perception of DPC evolve over the past five and a half years. There is still a gap, she says, between how existing members feel about the service and how prospective patients perceive it. Those who have experienced it consistently say the practice does not charge enough. Those who have not are understandably cautious about paying for something they do not yet fully understand.
But the experience speaks for itself. Cora describes patients coming out of their first intake visit visibly moved. "They always say, 'We've just never had an experience like this before, and we can't wait to tell all of our friends,'" she says.
DPC and the Future of Insurance
Asked whether DPC could eventually replace insurance, Cora takes a thoughtful view. She does not see DPC as a replacement for catastrophic coverage, but she does see it as a necessary counterbalance to a system where costs have spiraled without enough competition.
"I don't know that it has to be eliminated fully, but it has to be reined in," she says. She points to voices like Mark Cuban and the growing free-market healthcare movement as signs that the conversation is shifting in the right direction.
A Community That Lifts Each Other
For providers thinking about starting a DPC, Cora keeps it simple: if you truly believe in it, take the leap of faith.
"It does take hard work and it does take a lot of dedication. But if you really know that you do not believe in what the current insurance-based healthcare system has become, then you just need to take the leap of faith," she says.
What gives her confidence in that advice is the DPC community itself. In her experience, it is small but deeply supportive. She has never come across anyone unwilling to help a newcomer get started.
"It is unlikely that you are going to run into someone who isn't going to be able to help you with getting your feet off the ground," she says. "The answers are out there, and no one's protecting them."
For Cora, the underlying principle is simple. The DPC community grows stronger when more practitioners join it, and the ultimate goal, patient-centered care, is big enough for everyone.