Redefining Primary Care: Learning From Retail Health’s Failed Approach
TL/DR –
Retail giants such as Walmart and Walgreens once sought to revolutionize primary healthcare but have largely withdrawn after realizing the financial and operational challenges. Traditional primary care faces issues with accessibility, physician burnout, and patient engagement, causing a reactive rather than proactive approach to care. Specialists argue that the industry needs to shift to an advanced primary care model that prioritizes patient outcomes and high-quality care over patient volume, and allows patients more access to their primary care teams without cost restrictions.
Retail Giants’ Healthcare Experiment: What Went Wrong and the Future of Primary Care
Retail giants like Walmart and Walgreens once believed they could ‘fix’ healthcare, but after investing billions, they concluded that healthcare isn’t a sustainable business model. Retail healthcare may be convenient but it can’t replicate a meaningful primary care experience. The current retail health model lacks incentives that are clearly aligned for key stakeholders.
Retailers aimed to provide consumers with easy access to primary care, but financial incentives and operational costs were not value-aligned. The essence of a value-based care model ensures that providers, employers, and members are all engaged with care and are aligned on improving outcomes.
Despite the shortcomings of retailers, lessons about successful primary care innovation can be gained. These lessons can inform how to replicate and scale across the US and engage with members to drive them towards appropriate care before their conditions worsen and become costlier for the health ecosystem.
Where Retail Health Giants Went Wrong
Primary care plays a crucial role in reducing healthcare costs. The U.S. could save $67 billion in health costs if everyone used a primary care physician as their primary source of care. But the traditional primary care model is plagued by accessibility issues and a fragmented care experience.
Primary care clinics operate on a fee-for-service basis that prioritizes patient volume leading to an unsustainable workload, and consequently, physician burnout. The current model needs a shift from a transactional to a truly meaningful patient experience. The lack of clear alignment between patient, supplier, and care team incentives poses a significant challenge.
Primary Care Success Factors
Successful primary care revolves around holistic care from a provider who has built an ongoing relationship with the patient. Primary care should serve as the first stop in a patient’s health journey for basic care, and for questions about more specialized care. Visits to the PCP should be proactive rather than reactive.
To address the issues confronting primary care, the healthcare industry needs to transition to an advanced primary care (APC) model which prioritizes patient outcomes and high-quality care. APC emphasizes patient engagement and advocacy, with care teams playing a critical role in supporting patients.
Large employers like JPMorgan Chase are partnering with healthcare organizations to offer advanced primary care onsite to employees. This allows for a personalized care experience that enhances patient care.
Addressing the primary care problem in the US is crucial. Lessons can be learned from the failed investment of retail giants in primary care clinics. A successful primary care experience should encourage patients to have regular access to the same provider over time, with financial incentives clearly aligned for stakeholders for a manageable patient flow.
Primary care is the backbone of the U.S. healthcare system and needs reimagining. While retail health clinics were not the answer, new primary care models are emerging that produce better outcomes for patients, lower costs for members, and allow PCPs to engage more frequently with patients.
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