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Primary care physicians cannot wait and hope for solutions that may never come to fruition.
Good news for all those in primary care: Virtually everyone in the healthcare sector has come to see value in you. U.S. companies focused on primary care raised $16 billion from investors in 2021. Amazon made news recently for its $3.9 billion acquisition of primary care provider One Medical. The U.S. Department of Health and Human Services (HHS) recently announced that it would award $155 million to expand training for primary care residents in underserved and rural communities.
Bad news for primary care providers (PCPs) today: All of that is not nearly enough. It’s not enough to remove the daily pressure to see as many patients as possible and deliver quality care to them … not enough to decrease the immense operational and administrative burden they bear … not enough to help our communities achieve the good health that stems from productive relationships between PCPs and their patients.
PCPs face severe financial, clinical and operational burdens. They cannot wait and hope for solutions that may never come to fruition. This crucial segment of healthcare requires solutions today. What can be done?
Expand the definition of PCPs’ teams today
Stating the obvious, growing and strengthening the U.S. PCP population will take years. New PCPs won’t just require time to get into practice, they will also need time and grace to learn their profession and build their approach to care delivery. So, as we look to support current PCPs—all while making care more accessible for a growing number of patients—the healthcare industry at-large would benefit from taking a closer look at the deployment of integrated, expanded care teams.
Imagine a typical independent primary care practice today: physicians, nurses, advanced practitioners, and staff members all working furiously to address every patient inquiry, respond to all care-related and administrative issues, prepare each day to see as many patients as possible while constantly worrying about what might fall through the cracks. It’s even more exhausting than it sounds … and it becomes further complicated among rural populations because of logistical barriers and other social determinants of health.
Caring for these patients in a scalable and manageable way starts by admitting that the traditional care model does not work for them, at least not in an optimal way. The use of integrated, expanded care teams presents a clear and viable option—not the least of which because we all know that effective teams perform better than individuals can on their own. In an expanded care team model, PCPs’ expertise is augmented with care managers and coordinators, pharmacists, social workers, behavioral health specialists and more. These specialized resources connect with patients between their doctor visits, reaching them in the moments that matter to provide personalized support along the care journey. That includes everything from helping them stay adherent to their medications, to helping them with chronic condition management, to easing transitions of care, to ensuring that their PCP stays in the loop about other care that patients receive from specialists and other care providers.
For PCPs, the use of extended care teams requires vetting and trust; the right care team must be a transparent addition to a practice’s own, employed team. But executed correctly, the approach has been proven to alleviate provider and staff burden, while enabling providers to reach patients in ways and in times that otherwise would have presented a huge strain on staff resources.
Bolster the right teams with the right tools and payment models
All members of a high-functioning care team play a role in driving success in a patient’s health journey. But to create a cohesive experience that relieves pressure for providers and delivers better outcomes for patients, care teams must be connected through the right technologies … and those technologies must extend to PCPs and patients as well. That means a shared platform for all functions and phases of care management to ensure that all care team members can meet patients where they are, with understanding of that patients’ health journey at each step. In this way, the right technologies decouple the care experience from the doctor’s office or other physical space. Care can be provided and supported through multiple channels (in-person, video, secure chat) … and through multiple care team members.
To create a care experience like this, care teams must be able to execute seamless handoffs from one moment of care to the next. And they must be able to give visibility to the whole continuum of care so that PCPs can continue to be informed about patients’ care journeys even after patients have left the exam room. This requires trust. It requires PCPs to integrate care teams into their workflows. In many cases, it requires granting EMR access to enable care team-PCP communication in a common system. Most of all, it requires the intention to change old habits to create new results.
Nothing changes if payment models don’t change
I would be remiss if I did not mention the role that payment models play in all this—perhaps the most important role. We cannot move forward with transforming healthcare delivery if we don’t also transform healthcare payment. Aligning payment to patient outcomes is one step. The next step requires broader adoption of prospective payment models that support everything mentioned above: team-based care with diverse and specialized expertise, purpose-built technologies that pull the industry forward in areas like convenience, access and ease of information exchange.
Efforts like HHS’ investment toward the education and development of new PCPs are critical for the future of healthcare and overall wellness of Americans. But if we don’t also change the way the economics work for current and future PCPs and provide a measure of financial security to primary care, we continue to place our health futures at risk. Some 20 percent of physicians plan to exit the profession in the next two years. The Association of American Medical Colleges predicts a shortage of between 21,100 and 55,200 primary care physicians by 2032. It’s clear that too many current and future PCPs look at the specialty and feel like it’s simply not worth the toll it takes.
To shift that mindset, we must shift the payment models that ultimately drive the viability and attractiveness of primary care. If we can do all of that—if we can integrate and expand care teams and digital tools, if we can evolve payment models quickly—we can alleviate primary care burden and broaden access today. We can fulfill the promise of what primary care was always intended to be: personal, accessible, relationship-driven, whole health-focused.
Christopher Crow, MD, is CEO of Catalyst Health Group.