System change creates opportunity for new primary care models


Primary care no longer holes up solely in the primary care physician’s (PCP’s) office—just one manifestation of systemic change, a PricewaterhouseCoopers survey of physicians, employers, and consumers argues. According to “Primary Care in the New Health Economy: Time for a Makeover,” new payment models and changing demographics force different approaches for both the supply and demand sides of primary care. Those new models include convenient care, concierge care, digital health, independent practice nurse-led care, and house calls.

Primary care, in this view, will provide services for seven core consumer markets: the frail elderly, consumers with complex chronic disease, consumers with chronic disease, consumers with mental illness, healthy families, healthy adult enthusiasts, and healthy adult skeptics.

The survey, conducted by the company’s Health Research Institute, points out that the physician shortage that keeps everyone up at night is based on “outdated care-delivery models,” and innovations now being introduced could “reinvent primary care and close the gap.”

The nation spends $3.2 trillion on health care each year. “Revving up the role of primary care—with digital technology, a focus on prevention, and expanded roles for non­physicians—offers a cost-effective remedy,” the report states. “After decades of being undervalued in a fee-for-service system that emphasizes transactional medicine [a single type of treatment for problems believed to have a single cause] at times of distress, primary care is poised for an extreme makeover.” It won’t happen without taking some risks and challenging old assumptions.

What physicians think about new primary care models
Convenient care (retail clinics)
Increases patient satisfaction 47%
Increases access 69%
Do not now partner with or plan to partner with a retail clinic 83%
Concierge care
Concierge care will increase over the next decade 71%
Digital health
Would rely on certain DIY test results to prescribe medicine 42%
Implementing technology to teleconsult with patients and families 16%
PCPs will rely more on mobile apps and wearables 85%
Independent practice nurse-led care
Nurse practitioners/physician assistants should lead their own patient panels 56%
House calls
Nonphysician house calls will increase over the next 10 years 79%
What consumers think about new modes of primary care
Convenient care (retail clinics)
Visited a retail clinic in the past year 36%
Satisfied with care 95%
Would recommend retail clinics 89%
Concierge care
Value high patient-satisfaction scores when choosing providers 76%
Digital health
Open to a virtual doctor’s visit 60%
Would use a do-it-yourself diagnostic test 50%
Independent practice nurse-led care
Would see a nurse practitioner or physician assistant for care 75%
House calls
Interested in in-home care 66%

Source: PricewaterhouseCoopers, “Primary Care in the New Health Economy: Time for a Makeover,” November 2015

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