Advanced Primary Care

U.S. adults who regularly see a primary care physician have 33% lower health care costs and 19% lower odds of dying prematurely than those who see only a specialist. And if everyone used a primary care provider as their principal source of care, the U.S. could save $67 billion annually.

Despite these enormous benefits, misaligned financial incentives, infrastructure barriers and a lack of integration with other elements of care — including behavioral health — continue to severely constrain primary care’s potential.

For this reason, PBGH has defined the attributes of Advanced Primary Care. These include:

• The ability to receive common procedures without the need for a referral to a specialist
• Access to care that best meets patients’ needs, such as extended after-hours care and virtual care
• Comprehensive care that includes screenings and management of behavioral and social needs
• Coordinated care between primary care teams and other care providers
• Use of tools and systems that support population-based care and the provision of care management for patients with chronic conditions

PBGH has outlined a supporting measure set that establishes evidence-based clinical markers that collectively signal implementation of Advanced Primary Care. We’re working closely with payers and providers to test and ultimately implement the measure set in performance and shared-risk-based payment models in California and nationwide.