Advanced Primary Care

The Problem We’re Solving For:

Employers know that primary care is essential to a healthy workforce and employees’ access to a high-value health care system. Studies show that robust systems of primary care can lower overall health care utilization, disease and death rates and increase the use of preventive services.

Strong primary care also may reduce the negative effects of income inequality and is associated with more effective and equitable health services. Despite the enormous benefits, a host of existing market dynamics continue to severely constrain primary care’s potential, including misaligned financial incentives, infrastructure barriers and a lack of integration with other elements of care — including behavioral health.

That’s why PBGH has developed a set of advanced primary care attributes used by payers, providers and health care purchasers to incentivize high-quality, lower-cost primary care with patients at the center of every interaction. We are working to scale high-quality primary care through the development of a national network that is vetted to include a region’s highest performing primary and specialty care practices.

PBGH’s approach to advanced primary care redirects existing health care spend to high-quality, equitable and evidence-based care while holding total cost flat.

What We’re Working Toward:

PBGH and its members are working toward a model of ‘advanced primary care’ that:

• Redirects current health care spending to primary care and changes the way primary care is paid for, moving away from a fee-for-service system and toward flexible and prospective population-based payment.
• Uses rigorous outcomes and quality metrics to identify high-performing providers and drive patients to those providers.
• Enables comprehensive care that includes screenings and management of behavioral and social needs.
• Makes available clinical and claims data needed to enable coordinated care between primary care teams and other care providers, including a referral network to high-performing specialists.
• Uses tools and systems to address social determinants of health that support population-based care and the provision of care management for patients with chronic conditions.