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On Retainer:
Direct Primary Care Practices Bypass Insurance

http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/
PDF/O/PDF%20OnRetainerDirectPrimaryCare.pdf

excerpt:
Health reform act.
A DPC clause was written into
the Affordable Care Act (ACA) allowing retainer
practices to be included in the proposed insurance
exchanges, with the caveat that these practices
be paired with a wraparound insurance policy
covering services outside of primary care. It is the
only non-insurance offering to be authorized in the
insurance exchanges slated to begin in 2014; however,
there is no requirement that DPCs be included. See
Appendix for more information.