Although Under Threat, Primary Care is a Promising Health Solution for America’s Employers According to article in Health Affairs

While continuous access to a personal primary care physician is statistically proven to lead to significantly better health outcomes, primary care in the United States is on the decline and under threat, insist the authors of an article published in this month’s edition of Health Affairs, a leading health policy journal.

While healthcare costs are skyrocketing, and compensation for specialized practitioners grows robustly, primary care physicians’ salaries are declining and there is an increasing reluctance by medical school graduates to go into general practice, according to Drs. Martin Sepulveda, Thomas Bodenheimer, and Paul Grundy, co-authors of the piece entitled “Primary Care: Can it Solve Employers’ Health Care Dilemma?”


Sepulveda et al contend in the article that there are “Dozens of studies that a strong primary care sector is associated with lower health care costs and improved quality.” They cite recent work indicating 94% of Americans prefer to consult with a primary care physician, and that those who do have a 19% lower mortality rate than patients who see a specialist as their personal physician.

According to the authors, employers—at a time when they are paying a burgeoning percentage of their annual revenues on health care for employees in return for worsening health outcomes—have the leverage and the incentive to demand more primary care. “Primary care has the potential to contain health care costs, particularly by reducing ambulatory care-sensitive (ACS) hospital admissions, emergency department (ED) visits, and inappropriate specialty consultations,” write Sepulveda et al.

One way in which some employers are trying to adopt a more primary care-oriented model of health delivery for their employees is through promotion of the “Patient Centered Medical Home” (PCMH) model. In a PCMH, primary care physicians attend to the comprehensive health needs of their patients, including assisting them in navigating the different segments and sub-specialties of the medical system. The PCMH model also calls for an enhanced system of physician reimbursement that rewards PCPs for coordinating specialist care, and includes a fee-for-performance component, in addition to the current fee-for-service provisions.

Dr. Grundy, who serves as the Patient Centered Primary Care Collaborative’s chairman, sees promise in the work the PCPCC is doing to unite health care stakeholders around the concept of primary care. “Employers are sick of the care they are buying, and must demand a better product for their money,” he insists. “The medical home is the best way for employers to pay for the kind of care physicians want to provide, and their employees want and need to receive.”

The Patient Centered Primary Care Collaborative (PCPCC) is a group of large employers, trade associations that represent their health benefits interests, physician groups, and health benefits companies that have come together to increase awareness of and eventually implement the PCMH model on a broad scale.