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November 2, 2011

10 ways to expand primary care access

Daily Briefing

Primary care growth is now a top strategic priority for many hospitals and health systems. As increased physician employment tightens referral networks throughout the care continuum, organizations are racing to capture downstream volumes starting from the system’s front door: the primary care office.

Population shifts and payment reform will further heighten the focus on primary care. Emerging payment models, including readmissions penalties, episodic bundled payments, and shared savings programs, require effective ambulatory patient management for hospitals to succeed under new incentives.

However, many hospitals and health systems are poorly positioned to capture primary care share. Capacity is already backlogged—nationwide, primary care appointment wait times average 20 days—and the primary care physician (PCP) shortage shows no signs of abating. Meanwhile, demand for services is anticipated to grow by 15% across the coming decade.

To expand access to primary care services amid this capacity crunch, leading health systems are employing a two-pronged approach:

Elevating practice productivity

With the PCP shortage expected to hit 65,000 by 2025, few health systems should expect simply to hire or align their way to sufficient primary care access. Asking physicians to work longer hours is also likely unviable: 53% of PCPs already report feeling significant time pressure during patient visits, and a growing number of younger physicians are prioritizing work-life balance. Providers and health systems will instead need to evaluate new care delivery models and strategies such as:

  • Migrating primary care practices toward ideal practice size;
  • Strengthening care teams through more effective use of midlevel providers, clinical assistants, and even front-office staff;
  • Implementing group visits for targeted populations;
  • Deploying system resources to support practice efficiency improvements; and
  • Redesigning facilities for next-generation care processes.

Planning the coordinated network

Even when operating efficiently, primary care practices alone will not be able to meet expected demand. Health systems are currently exploring how to offload some care to alternative sites by positioning additional access points to supplement capacity and increase market share. These strategies include:

  • Engaging stakeholders in identifying ideal care locations;
  • Co-locating practices with urgent care centers and other ambulatory services;
  • Offloading care to integrated convenient care clinics;
  • Increasing worksite clinic presence; and
  • Offering e-visits based on payer and market receptivity.

Register now

Marketing and Planning Leadership Council members may explore these and other strategies for driving volume growth, responding to new payment models, and building patient loyalty by registering for a series of webconferences across November and December. Not a member? Visit our website to learn more.

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