Primary care is changing. Patient experience and expectations are paramount while demographics and corresponding health concerns are shifting, leading to more patient-centered care. The resulting changes could also benefit practitioners who are feeling the pressure of primary care physician shortages coupled with widespread burnout. As the healthcare industry grapples with longer wait times for shorter appointments and rising costs, direct primary care, technology, nontraditional providers, and other trends illustrate the future of primary care.
Trend 1: Value-Based Care
The fee-for-service model has long been the status quo in primary care. Physicians are reimbursed by insurance companies based on the quantity of patients they treat, rather than the quality of that care. Value-based healthcare rewards physicians for their patients’ health outcomes. It also removes incentives for providers to duplicate tests or treatments.
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Trend 2: Direct Primary Care
Direct primary care also eliminates the fee-for-service model currently prevalent in primary care. However, rather than payers reimbursing clinics based on outcomes, patients themselves pay for care with a membership-based structure similar to a gym or streaming platform.
Direct primary care offers patients more access to their primary care provider(s), including shorter wait times and longer appointments. Because care is based on a membership fee, rather than insurance reimbursements that require time-consuming administrative work, physicians have both more time to spend with patients and better work-life balance.
Direct primary care looks different for different patient populations. While more affluent individuals may pay thousands of dollars per month for around-the-clock access to their primary care physician and other healthcare practitioners (often called “concierge medicine”), direct primary care can also refer to practices providing routine preventative care for an affordable, predictable monthly membership fee and can even include in-home care.
Trend 3: Integrated Care
Primary care physicians traditionally serve as gatekeepers to the rest of the healthcare system. Patients call their PCPs when they don’t feel well. This becomes more challenging to maintain as primary care physician shortages increase and chronic diseases become more prevalent. One potential solution to this process is an integrated care practice that includes not only a primary care physician, but also advanced practice providers reducing the doctor’s patient load as well as “multidisciplinary care teams (MDCTs) [providing] an integrated approach to medical, behavioral, and social determinants of health.”
Trend 4: Technology
In primary care, telemedicine is perhaps the most obvious use of technology. COVID-19 increased the adoption of telemedicine and it is still more widely used than before the pandemic. The benefits of primary care via telemedicine include convenience and time savings. Patients can also seek treatment from providers who otherwise would not be accessible due to geographic limitations, which can increase access to culturally competent care and other specialized treatment.
Other potentially impactful uses of technology include precision medicine and AI’s role in both diagnostics and administrative work. Advanced technology also enables several other primary care trends. For example, electronic records allow for direct, in-home care as well as integrated care across specialties.
Trend 5: Nontraditional Providers
Retailers and payers are already playing a role in primary care. Amazon acquired One Medical, a membership-based primary care provider, in 2023 and offers Amazon Prime subscribers a substantially discounted membership. CVS offers primary care via clinics, in-home evaluations, and virtual appointments. Optum is a “health solution and care delivery organization” owned by the same parent company as UnitedHealthcare, a health insurance company serving more than 27 million people. Nontraditional providers can offer care in places where patients already spend time, including their homes. They also bring technology-backed efficiencies small practices are unlikely to match in the near future.