Advanced Primary Care

What it is, what it does, how to get it, and why should employers care.

By Michael Fondell
Partner of BizMed Solutions

As any business owner can tell you, changing a product or a service for the better, requires thorough understanding, from nuts to bolts, of said product or service. Tinkering with a business you don’t fully understand often leads to disastrous consequences. Another thing any business owner can tell you is that health care is in dire need of changing for the better. Many powerful interests have tried to “fix” health care with little to no expertise in the actual delivery of health care, and sadly and predictably they all failed. Health care costs in the U.S. are steadily growing and quality of service seems to be deteriorating year over year. Employers and employees are increasingly paying more for much less.

If corporations that sell paper goods online or canned goods in megastores, and an all-powerful government cannot solve the health care problem, then who has the deep understanding and proper expertise to do so? The answer is deceptively simple: Primary Care physicians. Primary Care is the basis of all health care. It is the entrance point into the medical system and everything flows from there. High quality, or advanced, Primary Care is the primary lever for obtaining high value health care. Employers who want to control their health care costs while increasing the quality of their benefits, must find, purchase, and foster Advanced Primary Care for their employees.

Finding Advanced Primary Care is not an insurmountable task. Employers should begin the search by asking their current benefits consultant or plan administrator if Advanced Primary Care is included in their networks. However, a simple yes, or some other reassuring platitude, is not sufficient. Employers should require that whoever is implementing Advanced Primary Care for them must present a detailed qualitative and quantitative evaluation and monitoring framework, including instruments to customize the service to the employer’s need, as well as processes to support accountability and improvements over time.

Advanced Primary Care is not a silver bullet. There are no silver bullets in health care. Advanced Primary Care can generate anywhere between 5% and 15% savings in total health care costs, depending on availability, intensity, geography, and employees’ demographics. Advanced Primary Care can be combined with other benefit designs and contractual relationships with hospitals and ancillary services to yield more savings. However, omitting Advanced Primary Care from such arrangements, while still saving money in the short-term, will likely decrease quality of care and subsequently increase long-term costs.

In summary, employers who realize that in health care too, offense is the best defense, should consider proactively integrating Advanced Primary Care in their health care benefits package. Our new white paper provides a detailed description of Advanced Primary Care frameworks, along with a clear implementation roadmap for employers who are fed up with the unsustainable status quo and who choose to take control of their health care expenditures.

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