The short version
Using DPC Finder's 2,663 hand-mapped direct primary care and concierge practices against the US Census Bureau's Vintage 2025 state population estimates, Wyoming, Colorado, and Montana rank highest for DPC practices per 100,000 residents. Rhode Island, Connecticut, and Alaska rank lowest.
That ranking is a ratio, not a verdict. A low number doesn't automatically mean an open market, and a high number doesn't mean a saturated one, it just means this is what the data actually shows once you count real practices against real population. Read it as a starting point for your own research, not a conclusion.
The full ranking
| Rank | State | Practices | Population (2025 est.) | Per 100k residents | | --- | --- | --- | --- | --- | | 1 | Wyoming | 16 | 588,753 | 2.72 | | 2 | Colorado | 147 | 6,012,561 | 2.44 | | 3 | Montana | 25 | 1,144,694 | 2.18 | | 4 | Idaho | 39 | 2,029,733 | 1.92 | | 5 | Kansas | 57 | 2,977,220 | 1.91 | | 6 | Maine | 26 | 1,414,874 | 1.84 | | 7 | Oregon | 61 | 4,273,586 | 1.43 | | 8 | Washington | 112 | 8,001,020 | 1.40 | | 9 | Vermont | 9 | 644,663 | 1.40 | | 10 | Oklahoma | 53 | 4,123,288 | 1.29 | | 11 | Nebraska | 25 | 2,018,006 | 1.24 | | 12 | Florida | 275 | 23,462,518 | 1.17 | | 13 | North Carolina | 130 | 11,197,968 | 1.16 | | 14 | Wisconsin | 68 | 5,972,787 | 1.14 | | 15 | New Mexico | 23 | 2,125,498 | 1.08 | | 16 | Arizona | 81 | 7,623,818 | 1.06 | | 17 | Missouri | 66 | 6,270,541 | 1.05 | | 18 | Minnesota | 61 | 5,830,405 | 1.05 | | 19 | Utah | 34 | 3,538,904 | 0.96 | | 20 | Delaware | 10 | 1,059,952 | 0.94 | | 21 | Indiana | 65 | 6,973,333 | 0.93 | | 22 | New Hampshire | 13 | 1,415,342 | 0.92 | | 23 | South Carolina | 51 | 5,570,274 | 0.92 | | 24 | Virginia | 81 | 8,880,107 | 0.91 | | 25 | Iowa | 28 | 3,238,387 | 0.86 | | 26 | Tennessee | 57 | 7,315,076 | 0.78 | | 27 | Texas | 243 | 31,709,821 | 0.77 | | 28 | Ohio | 88 | 11,900,510 | 0.74 | | 29 | Georgia | 80 | 11,302,748 | 0.71 | | 30 | Nevada | 23 | 3,282,188 | 0.70 | | 31 | West Virginia | 12 | 1,766,147 | 0.68 | | 32 | Michigan | 66 | 10,127,884 | 0.65 | | 33 | Mississippi | 18 | 2,954,160 | 0.61 | | 34 | Pennsylvania | 76 | 13,059,432 | 0.58 | | 35 | Arkansas | 18 | 3,114,791 | 0.58 | | 36 | Illinois | 72 | 12,719,141 | 0.57 | | 37 | Maryland | 35 | 6,265,347 | 0.56 | | 38 | Alabama | 29 | 5,193,088 | 0.56 | | 39 | South Dakota | 5 | 935,094 | 0.53 | | 40 | Kentucky | 22 | 4,606,864 | 0.48 | | 41 | Massachusetts | 30 | 7,154,084 | 0.42 | | 42 | North Dakota | 3 | 799,358 | 0.38 | | 43 | Louisiana | 17 | 4,618,189 | 0.37 | | 44 | New Jersey | 35 | 9,548,215 | 0.37 | | 45 | District of Columbia | 2 | 693,645 | 0.29 | | 46 | New York | 56 | 20,002,427 | 0.28 | | 47 | Hawaii | 4 | 1,432,820 | 0.28 | | 48 | California | 107 | 39,355,309 | 0.27 | | 49 | Alaska | 2 | 737,270 | 0.27 | | 50 | Connecticut | 6 | 3,688,496 | 0.16 | | 51 | Rhode Island | 1 | 1,114,521 | 0.09 |
Every practice count comes from DPC Finder, Tabflows' own hand-mapped directory. Every population figure is the Census Bureau's July 2025 estimate, cited above, not something we measured ourselves.
Why the low end isn't automatically an opportunity
A handful of small, dense states (Wyoming, Montana, Vermont) sit at the top mostly because a modest practice count divides into a small population. That's real math, not a signal those states are somehow better DPC markets than California or New York, which sit near the bottom mostly because of the opposite: a huge population dividing a comparably modest practice count.
What this ranking is actually useful for is a first pass, not a final answer. Before reading a low number as "underserved," it's worth checking things this dataset doesn't capture: local insurance and employer-health-plan norms, whether concierge medicine already fills a similar niche in that market, household income, and the practical realities of building a referral network from scratch.
If you're actually scoping a launch
This ranking answers "how many DPC practices already exist here." It doesn't answer "how many members would I need," "what would it cost to get open," or "how do I find my first 100 patients." Tabflows has free tools for those:
- DPC break-even calculator: how many members cover owner pay, rent, staff, software, and overhead.
- DPC startup cost calculator: a launch budget from legal setup through operating runway.
- First 100 members worksheet: a copyable plan for finding your first 100 patients through local trust, referral partners, and founding-member offers.
Each state's own DPC Finder page shows this same per-100k figure alongside the full list of practices already there, if you want to check a specific state without reading the whole table.
FAQs
Which states have the fewest DPC practices relative to population?
By practices per 100,000 residents, Rhode Island, Connecticut, Alaska, California, and Hawaii rank lowest in Tabflows' DPC Finder dataset as of September 2026. That's a ratio of listed practices to population, not a measure of unmet demand or a guarantee those markets can support a new practice.
Which states have the most DPC practices relative to population?
Wyoming, Colorado, Montana, Idaho, and Kansas rank highest by practices per 100,000 residents in the same dataset. Several of these are lower-population states where a relatively small practice count still produces a high per-capita ratio, worth keeping in mind when reading the ranking.
Does a low density state mean it's a good place to open a DPC practice?
Not by itself. This ratio only measures how many listed practices exist relative to population. Local insurance markets, income levels, existing concierge or membership-care options outside this dataset, referral culture, and real estate all matter and aren't captured here.