- Comparative Effectiveness
- Evidence-Based Design and Overuse
- Health Accounts and Account-Based Plans
- High-Performance Networks/Centers of Excellence
- Medical Plan Design and Administration
- On-Site Health Centers and Convenience Care Clinics
- Patient Safety and Quality
- Payment Reforms/Pay-For-Performance
- Pharmacy Plan Design
- Primary Care
- Specialty Pharmacy
- Transparency and Reference-Based Pricing
- Vendor Management
Why Employers Care
As employers work to improve employee health and control health care spending, reinvestment in primary care is an essential strategy. Research in the U.S. and abroad indicates an association between a strong primary care system, better health outcomes and lower spending.
Unfortunately, U.S. primary care is in trouble. According to the Center for Studying Health System Change, only 37% of doctors currently specialize in primary care, which is much lower than in other developed countries.1 The American Association of Family Physicians (AAFP) predicts a shortage of 40,000 family physicians by 2020.2 Practitioners are leaving the field and many medical graduates reject careers in primary care due to lower incomes compared to specialists and stressful working conditions.3
The way physicians are paid is part of the problem. Volume and procedures are rewarded, while the value of prevention and early management of health problems, chronic care management, coordination of services, efficient use of technology, and the avoidance of unnecessary procedures go unrecognized. The Patient-Centered Medical Home is a model that embodies advanced primary care characteristics. It is becoming more prevalent across the country, alongside new provider payment methods that recognize the value of primary care.
What Can Employers Do?
Employers can play a role in building a strong primary care infrastructure through health benefit design, purchasing practices, employee engagement strategies, and public policy advocacy.
The National Business Group on Health's Primary Care Action Agenda recognizes that primary care is foundational to a high quality, efficient and effective health care system and recommends the following system reform steps:
- Build primary care capabilities including health information technology to enable efficiency, quality and safety in practices of all sizes;
- Reform physician payment to recognize the value of primary care and primary care-like services;
- Communicate the value of primary care to employees; and
- Increase the supply of primary care clinicians with a variety of methods including education and loan programs.
Relevant Tools and Resources Include:
References (show references)
1 Bodenheimer, T. and Pham H.H.Primary Care: Current Problems and Proposed Solutions
May 2010, Health Affairs, Vol. 29, No. 5.
2 Phillips R.L. and Starfield B. Why does a U.S. Primary Care Physician Workforce Crisis Matter? American Family Physician, 70:3, August 1, 2004.
3 Zerehi, MR. How is the Shortage of Primary Care Physicians Affecting the Quality and cost of Medical Care?: A Comprehensive Evidence Review. American College of Physicians White Paper, 2008.
Page last updated: September 14, 2012