The National Primary Care Transformation Summit, held in early December, offered a fascinating glimpse into the current landscape of primary care in the United States. Diverse sessions featured insights from leaders spanning the spectrum of primary care, representing both large corporations and small businesses. Across these presentations, I noted three themes:
Our nation is grappling with a burgeoning crisis in primary care, with too few primary care providers as well as payment structures that do not sustain growth. It is imperative to focus efforts nationwide to restore and build this critical area of healthcare. Maximizing health and minimizing expenditure hinge upon extending the well-being of as many individuals as possible, and this starts with robust primary care. A healthcare system with primary care at the center not only excels in quality but also optimizes efficiency. Practices anchored in value-based care are better equipped to advance these goals than those that operate under fee-for-volume. Emphasizing this shift will be pivotal in attracting the next generation of primary care providers.
Various primary care models were showcased, such as CareMax’s much-publicized “whole person health” approach. CareMax “health centers” include the primary care physician at the hub, surrounded by an array of specialty services, such as pharmacy, dental, and vision, and broader supports such as community/social/transportation. Similarly, Oak Street Health highlighted their commitment to delivering high-quality, cost-effective care through a holistic model, often involving visits to a patient's home environment to better understand and address social determinants that can impact health outcomes. Additionally, a group of nurse practitioners (NPs) discussed the rise of NP-owned practices. They underscored how nurses are trained in a holistic approach to healthcare, and thus NP-owned practices are well positioned to be at the forefront of primary care both at home and in the community.
The ongoing national shift from fee-for-service to value-based contracting centers on primary care. Effective primary care necessitates the management of patient “panels” on a per-provider or per-clinic basis. For example, Optum divides its primary care patients into panels, leveraging data and analytics to enhance their approach. Many speakers highlighted the potential of Artificial Intelligence (AI) in empowering primary care practices and mitigating burnout by synthesizing data from diverse sources, which is often a cumbersome and inefficient process when done manually through chart review. The promise of AI is that it can enable clinicians to allocate more time to do what they are trained to do, namely providing direct clinical care to patients. The shift to value-based care will only accelerate and it will be exciting to see what the future holds for primary care and beyond.