Reimbursement challenges, changing preferences among younger patients, and an aging population who need expanded access were all topics in a recent panel discussion on the current and future state of primary care in this country. The discussion took place among participants in the Cleveland Clinic 2018 Medical Innovation Summit and involved a look at the possible future of primary care.
Experts on the panel included Anil Jain, MD, VP & Chief Health Information Officer, IBM Watson; Peter Antall, MD, President & CMO, American Well; Joe Schrick, Vice President Fitness Segment, Garmin; Bonnie Clipper, Vice President of Innovation, American Nurses Association; and Nirav Vakharia, MD, Vice Chair, Population Management, Cleveland Clinic.
The general consensus was that primary care is changing and is faced with a number of challenges, particularly those around reimbursement and the time spent on earning those payments. Physicians are being asked to focus on value-based care, which may involve extensive reporting and adhering to new regulations established by the Centers for Medicare & Medicaid Services (CMS) for their Medicare patients. The panel discussed their view that physicians are spending too much time on administrative work, which takes away from the time they can spend with their patients.
Additionally, the varying demands and preferences of the generations was discussed. Millennials and younger patients are very technology-oriented. They tend to take advantage of wearables and apps, prefer telemedicine over in-person visits, and engage in technology that monitors their health and fitness. The challenge with this dependency on technology, noted the panel, is that there is no primary care physician involved to coordinate care that may be necessary for an injury or illness.
On the other end of the generational spectrum, as the patient population ages, more elderly patients are finding they cannot access primary care for various reasons. A tendency toward chronic and complex conditions in older patients requires more of the primary care physician’s time and, again, reporting requirements at the CMS level for incentives and reimbursements.
The panel moderator, Dr. Jain, noted that “We know that primary care is under siege. We have a lot of transformation happening in health. Primary care doctors and primary care practitioners are being asked to deliver high quality and high value care. But they’re not being given all the necessary tools to do so.”