Is Primary Care’s Role Keeping Up with Health Demographics?

November 19, 2015 - Is primary care here to stay, but only if it receives a heavy-handed makeover? According to new research from PwC's Health Research Institute (HRI), redesigned primary care system is best apt to deliver top-notch value to demanding purchasers.

Previous reports about significant physicians shortages topping 90,000 by 2025 and the possible upcoming detrimental impact on a growing aging patient population are old news, says HRI, maintaining this information may be merely based on antiquated care delivery models.

Based on key findings from interviews with 25 executives and surveys from 1,500 clinicians and 1,000 consumers, HRI says the future of primary care must evolve to become more concentrated.

"Primary care needs to shift from its traditional role of 'gatekeeper' to an array of specialties and instead become a more engaged, central part of the system,” explains Kelly Barnes, PwC’s US Health Industries Leader. “This change is being driven by the demands for greater value, consumer need for convenience, and changing health demographics.”

“Rather than playing its historical role as gatekeeper to a splintered array of specialties, primary care has to become the nexus, providing simplicity, value and better health outcomes,” asserts HRI.

“The primary care market is poised for a makeover. Faced with new payment models and an aging population with chronic conditions, the health sector looks to a reimagined primary care ecosystem to help deliver on the promise of value.”

According to Simon Samaha, MD, a PwC Principal, as both healthcare costs and demand increases, primary care practitioners need to reassess how their business models can promote value.

"We're going to see non-traditional players shake up the industry using new technologies and innovative approaches focused on convenience for patients and value for providers," Samaha states.

PwC’s top 4 key findings:

• Purchasers are banking on primary care to save money – for example, the US government is pumping billions of dollars into primary care improvements. Employers are igniting change by adding lower cost, more convenient primary care benefit plan options such as telehealth services.
• Consumers are selecting primary care that fits their lifestyles. HRI found that 82% of consumers would be open to non-traditional ways of getting medical care.
• New entrants are disrupting the healthcare industry with innovative primary care models offering convenience and value to consumers and purchasers.
• Some primary care traditionalists are adapting to stay relevant. One-third of physicians are altering their business model to adapt to changes in the marketplace.

Numerous industry experts weigh in

“Just as the health food aisle once had 100 items and now has 1,000, primary care is now being segmented down to more and more options,” states Chris Stenzel, Senior Vice President for Business Development and Innovation at Kaiser Permanente.

“We need to flip the system on its head,” asserts Nancy Gagliano, MD, Chief Medical Officer of CVS/minuteclinic.

“There is a cadre of patients that wants to see the primary care physician every time but that group is shrinking,” adds Richard Kalish, MD, from Lahey Health’s primary care division.

“After decades of being undervalued in a fee-for-service system that emphasizes transactional medicine at times of distress, primary care is poised for an extreme makeover,” HRI writes. “The time is right for its true worth to be revealed — and rewarded.”