Redesigning Primary Care: A Strategic Vision To Improve Value By Organizing Around Patients’ Needs

Michael E. Porter, Erika Pabo, Thomas H. Lee

Health Affairs · 2013 · 239 citations · 13 references

Concepts

TL;DR

Primary care in the U.S. struggles to attract physicians and secure infrastructure investments, largely due to a lack of a comprehensive strategy. The authors propose a patient‑value framework to provide a comprehensive strategy for sustaining and improving primary care. The framework organizes primary care around patient subgroups with similar needs, delivers team‑based services throughout the care cycle, measures outcomes and costs by subgroup, adjusts payment to bundle reimbursement and reward value, and integrates subgroup teams with specialty providers.

Abstract

Primary care in the United States currently struggles to attract new physicians and to garner investments in infrastructure required to meet patients' needs. We believe that the absence of a robust overall strategy for the entire spectrum of primary care is a fundamental cause of these struggles. To address the absence of an overall strategy and vision for primary care, we offer a framework based on value for patients to sustain and improve primary care practice. First, primary care should be organized around subgroups of patients with similar needs. Second, team-based services should be provided to each patient subgroup over its full care cycle. Third, each patient's outcomes and true costs should be measured by subgroup as a routine part of care. Fourth, payment should be modified to bundle reimbursement for each subgroup and reward value improvement. Finally, primary care patient subgroup teams should be integrated with relevant specialty providers. We believe that redesigning primary care using this framework can improve the ability of primary care to play its essential role in the health care system.

References

13