Primary Care & Health Care Consultants
“It’s much more important to know what sort of patient has a disease than what sort of disease a patient has.” -William Osler, Father of Modern Medicine
Primary Care providers’ role as lead counselors and navigators is changing. When emergency rooms replaced physicians, because they had predictable hours and no payment barriers, costs skyrocketed. As a result, health reform, PPACA in 2009, HCERA in 2010, and ACA in 2020, include multiple strategies to move patients away from expensive care sources. Care management models are encouraged and will be tried, funded, evaluated and challenged. COVID-19 advanced telehealth as a substitute for in-person visits.
Provider-consumer relationships, electronic health records, value models, chronic disease care management and changed incentives dominate the models. Accreditation bodies, NCQA, URAC and the Joint Commission, are defining Primary Care Medical Homes (PCMH). Pharmacies are adding clinics; insurers and others are building in-house primary care systems, using nurse managers and navigators. Private equity concierge models are gining traction. States are encouraged to experiment. So, models differ across state lines. In 2021, despite small incentive arrangements, primary care providers will remain underpaid and shortages are predicted. Accustomed to on-demand services, customers are creating their own work-arounds, including Dr. Google.
PDA Primary Care Offerings:
- Briefings on new primary care models
- Impact analysis
- Emergency departments
- Physician networks
- Hospital inpatient and outpatient services
- Pharmacy
- Specialist referrals
- Facilitation for transition to medical home, patient-centric models, and pop-ups
- Outcome-based incentive payment system for primary care providers (MIPS)
- Facility space retrofit for customer centered, medical home
Primary Care Experience:
- More than 40 Rural Health Clinics
- Urgent Care/ Primary Care hybrids
- Hospital-owned practices
- Accountable Care Organizations