A Primary Care Strategy is Essential for Growth!
Academic Health Systems (AHSs) have historically placed less emphasis on primary care. However, the accelerating dissemination of medical knowledge and technology to community health systems and their increasing employment of specialists disrupt historical AMC referral practices. In today’s healthcare landscape, capturing attributed lives and managing risk hinges on bolstering AHS primary care capabilities. Adding additional challenges, payers, retail organizations, and private equity-funded groups are actively acquiring independent primary care practices as a strategic move to manage risk. In doing that, they often seek to divert patients to owned facilities and lower-cost sites of care.
Academic Health System Options
AHSs have two options: Directly employing primary care providers or adopting an alignment model, such as a focused clinically integrated network (CIN). As new, higher-value primary care network models emerge, the goal should be to deliver significantly lower total cost of care and better outcomes while reducing the administrative burden on physicians, fostering a collaborative environment, mitigating burnout, and providing financial stability for all parties. Doing this will drive sustainable growth!
New Primary Care CIN Models – Critical Success Factors to Align with Independent PCPs:
Make it meaningful: The days of “network light” are gone! The financial value of being a primary care network participant must be meaningful. In addition to providing financial stability, the network should improve the clinical practice of medicine. Participating PCP benefits should include improved contract terms, funds flow models aligned with total cost of care, clinical outcomes, network efficiency, and proactive participation in population health initiatives. Management of relationships between the AHS and the physician practices should be executed flawlessly, not as an afterthought.
Don’t underestimate the threat from agile competitors: The increasing number of new entrants acquiring primary care physicians must raise concern for health systems. Prominent payers, retail providers, and private equity-funded groups are actively acquiring primary care groups at an accelerated pace fueled by large business development teams. Remarkably, these corporate entities are not subject to the same fair market value restrictions imposed on health systems. This phenomenon carries profound implications for patient access to AHS sites of care.
Maintain organizational commitment: Academic health systems must
In summary, academic health systems must not delay locking down an effective primary care alignment strategy!