Primary care is the foundation of the U.S. health care system and accounts for 55 percent of the 1 billion physician office visits each year in the United States, yet 50 million Americans live in areas with an under-supply of primary care physicians. A recent UnitedHealth Group report, “Advancing Primary Care Delivery: Practical, Proven and Scalable Approaches,” details key building blocks for expanding primary care capacity and improving service delivery, including:
- Leveraging a diverse workforce by advancing effective roles for nurse practitioners (NPs) and physician assistants (PAs). A significant barrier to achieving more dramatic and rapid progress is payment policy. Medicare and Medicaid generally reimburse less for services delivered by NPs and PAs than for the same services when performed by physicians.
- Assembling multi-disciplinary care teams to help practices see more patients. A primary care physician with a panel of 2,000 patients would need to spend an estimated 17.4 hours per day to provide recommended preventive, chronic, and acute care — and many primary care physicians have larger panels.
- Utilizing health information technology (HIT), including electronic health records and interoperable data exchange. Allowing primary care practices to organize and disseminate information across the delivery system in real time will improve care coordination, increase quality, and lower costs.
- Leveraging the retail health infrastructure, which holds the potential for large-scale innovation in primary care. Evidence indicates that the quality and cost of services provided by retail clinics offer significant value, expanding access to primary and preventive care and reducing unnecessary utilization of costly services, such as hospital admissions.
- Reaching patients where they live by delivering primary care and preventive services to individuals in their homes. A key advantage of conducting clinical visits in the home is the review of environmental and social conditions, which provides valuable information and context to inform an individual’s treatment plan.
The report concludes there is no single set of clinical, organizational, and financial models that successfully expands primary care capacity and improves service delivery, but multiple complementary pathways that can be tailored to local market conditions and policy environments.