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Bestermann, Jr., MD: Primary care 3.0 and Why We Need to Unlock the Full Potential of Primary Care

Why We Need to Unlock the Full Potential of Primary Care

There are powerful reasons to move to a value-based primary care system. Highly effective primary care is an indispensable piece of that effort. Research shows that a focus on primary care is associated with better health, lower costs, lower mortality, higher patient satisfaction, fewer ER visits, and hospitalizations. Primary care provider reimbursement generates just 7.7% of healthcare costs but PCPs direct most spending through their referrals.

It is important to recognize that the costs of care are not distributed evenly:

  • Over 50% of commercial patients generate almost no costs.
  • Patients with chronic disease generate 85% of our bloated health care costs.
  • Just 5% of patients generate over half the costs, in part, because they don’t receive effective primary care upstream to reduce serious comorbidities downstream.

Primary care has already begun to segment. Hospitalists and urgent care providers are organized to meet the needs of special populations. Primary care teams that focus on chronic conditions will be critical to improve health and save money.

Primary Care 1.0

Chronic kidney disease (CKD) is rapidly increasing in our country and the incidence of dialysis is much higher if you are poor or black. If the poverty level in a neighborhood is 25% vs less than 5%, 4 times as many people go on dialysis. Black patients are 4 times more likely to go on dialysis when compared with whites. In the southeast, black patients may have 15 times the dialysis risk of white patients. Why is that? It is not racial. It is not genetic. Black and whites are 99.9% genetically identical. It is socioeconomic.

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