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Advanced Primary Care: The Solution to Primary Care’s Problems
By: Melina Kambitsi, Ph.D., SVP of Business Development & Strategic Marketing, The Alliance 

In a perfect world, primary care would be used first, most frequently, and would have built-in patient navigation. Instead, its usage has been on the decline, so let’s dig into how Advanced Primary Care (APC) begins to solve its problems.

Primary Care's Problems

Consolidation

Consolidation remains the leading cause of independent physician and practice loss; the percent of primary care physicians that worked for large health systems jumped from 28% to 44% between 2010 and 2016 alone.

And because primary care practices rely heavily on fee-for-service payments, the pandemic has only exacerbated consolidation rates.

 

Low or No Access


Because primary care practices are being consolidated or closed, there’s a lower supply of physicians. Their uneven geographic dispersal leads to an inadequate supply of appointments.

According to the Health Resources and Services Administration (HRSA), more than 80 million people live in what they consider a “Primary Care Shortage Area.” This designation essentially means the supply of primary care physicians does not meet the needs of the local population. (3,500:1 ratio of patients per physician.) Nearly 20% of patients reside in a health professional shortage area.

 

Low Utilization


Between 2008 and 2016, primary care visits dropped by almost 25%. And while spending on primary care services fell 6% between 2012 and 2016, it increased by 31% for specialty care across the same timespan.

Fragmented Care

Not only is primary care being offered in less places and used less by patients, it’s also often organized in a way that prevents physicians from understanding and addressing the situational factors in patients’ lives. Previously, primary care physicians approached patient needs from a generalist standpoint; they addressed a broad variety of symptoms and focused on holistic care rather than seeing patients for individual health concerns.

The Advanced Primary Care Solution

The fragmented, impersonal, and sometimes inaccessible primary care options wrought by the pandemic have highlighted our need for a new primary care solution, and employers are gravitating towards APC due to its unique benefits.
 

Meaningful Relationships


APC creates long-standing, continual relationships with patients. Those trusted relationships reach patients in ways that specialized care can’t.
Physicians understand their work history, mental health history, and family life. That creates a better foundation to accurately diagnose health issues, recognize them earlier, and deploy appropriate care mechanisms to manage them.

 

Holistic Health Care


APC treats the whole person and can identify and treat a broad spectrum of health concerns. This is key to preventative care; treating common chronic illnesses before they evolve into more serious (and costly) health issues.
 

Care Coordination


Traditionally, patients are slotted into impersonal 20-minute appointments. From there, the patient may be sent to a series of specialists who, due to the nature of their profession, are focused on a specific diagnosis – there’s no “quarterback” combining diagnoses, comparing notes, and coordinating care.

APC utilizes team-based primary care, where the primary care doctor serves as the quarterback and uses a team to coordinate their efforts.

 

Lower Costs


APC ditches the fee-for-service payment model and measures success by a patient’s health status rather than the revenue generated from visits, tests, and procedures.Likewise, the need for costly specialty care becomes less likely as their issues are treated and managed by their primary care doctor.
 

Smarter Referrals


When a physician does have to refer a patient to a specialist, they can work with their team to make a high-value decision and help the patient navigate their in-network options. For example, an APC clinic is more likely to refer patients who need an MRI to a free-standing clinic instead of a hospital, which can save hundreds (sometimes thousands) on a single test.
 

Improved Access


When an employer utilizes an APC clinic, monthly per-person fees replace the traditional fee-for-service model, and typically, patients’ co-pays are eliminated (or negligible). Removing that financial barrier drastically increases the patient’s utilization of high-quality care, and as a result, patient groups report higher levels of engagement and satisfaction.

Plus, because the clinic is at or near an employer’s worksite, the patient doesn’t have a lengthy commute.

APC Clinics with The Alliance

Want to know more about APC? Interested in learning how to create or join an APC clinic for your employees? Reach out to our Business Development team!


Melina joined The Alliance in 2017 and leads the teams responsible for business development, client development, and strategic marketing.
 
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