Primary-care partnerships help payers boost patient outcomes

Even before the pandemic, the primary care landscape was evolving toward greater use of retail, telehealth, and virtual care options. This trend is being driven by such factors as decreased loyalty between patients and primary care providers and consumers’ desire for more convenient, less disruptive access to care.

As new primary-care models replace legacy primary care, payers have numerous opportunities to pursue partnerships that lead to not only better health outcomes and lower per-patient costs, but also competitive advantage in the market. Such partnerships allow payers to simultaneously share risk and expand their footprints by coordinating patient care across numerous points of access.

In this paper, KPMG gives an overview of three emerging primary-care models and their relative advantages for payers that are interested in pursuing partnerships:

• Digital, direct-to-consumer models rely on technology to provide services that meet members when and where it is most convenient for them, thereby removing specific barriers to care, such as transportation.
• Retail models are evolving from treating low-acuity conditions to offering full primary-care services all under one roof.
• Community-based models aim to help disadvantaged and underserved populations with not only direct primary care, but also adjunctive issues that can impact well-being, such as social determinants of health.