Primary care has progressed from the days of the family doctor who did everything to the primary care physician (PCP) as medical home for the patient, coordinating care with other physicians and medical providers. Where does primary care go from here?
Many experts believe that primary care will continue to increase in importance, even while the number of PCPs may be decreasing. The Association of American Medical Colleges (AAMC) commissioned a study recently on impending physician shortages. The study found that for PCPs, “the estimated shortage will be between 8,700 and 43,100 physicians by 2030.”
The shortage occurs as the need for primary care grows among an aging population. As patients become eligible for Medicare, additional requirements around providing value-based care and reporting regulations imposed by the Centers for Medicare & Medicaid Services (CMS) will affect the future of primary care.
On the positive side, innovation will improve the effectiveness and efficiency of primary care. The use of electronic health records (EHRs) will enable PCPs to better coordinate care, track their patient’s medical history, and plan for an improved healthcare plan for that patient. Implementing EHRs will become a requirement for those PCPs participating in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Quality Payment Program (QPP).
Value-based care will increase in importance for PCPs. Medicare reimbursement will depend on the PCP’s ability to provide quality healthcare. Many private insurers, as well, are moving toward a value-based reimbursement system, and away from the fee-per-visit model. Rather than track the number of patient visits, the PCP will be called upon to track and document the medical progress of the patient.
A growing number of PCPs are opting out of the traditional insurance reimbursement model completely, instead forming direct primary care (DPC) practices. In the DPC model, patients pay a monthly membership fee that covers basic primary care services. The DPC physician is able to spend more time with each patient, see fewer patients per day, and realize greater rewards in terms of financial stability and healthcare outcomes.