It’s no coincidence that nine of the 10 best-selling NHL player jerseys are worn by forwards: fans love the guys who score the goals. But defensemen, despite their relative unpopularity, are essential to victory: their vantage point allows them to see plays as they develop, they are vocal leaders directing their team’s adjustments, and they are responsible for closing gaps that the offense might exploit.
Primary care doctors play a similar role in a health care system: they can see the full picture of a patient’s health, they often run point on care management, and they are well-positioned to catch acute issues before they become a serious problem. Unfortunately, similar to defensemen in hockey, they often aren’t given appropriate recognition for their critical contributions. But if we hope to improve the level of care in this country and reduce ever-expanding health care costs, we need to place a higher value on primary care.
Our country has a hole when it comes to primary care. Some indicate a shortage of over 23,000 primary care physicians as soon as 2025, and it isn’t hard to figure out why: primary care features a high rate of physician burnout. Studies have found that primary care physicians perform almost two hours of required paperwork for every one hour of patient care, which contributes to an estimated 18 hours needed to complete all of their work each day. Beyond that, traditional fee-for-service models reimburse at low rates for primary care visits, meaning that primary care providers have to see a higher volume of patients every day to cover their costs. All of this contributes to primary care physicians retiring early or moving to hospital settings.
Essentially, our system is set up to discourage primary care practice, and yet study after study reports on the importance of primary care for improved health outcomes.
That’s why businesses need a new kind of health plan solution, one with a primary care-centered clinical model, where primary care providers are paid more in exchange for delivering high-value care. Paying primary care providers more isn’t just the right thing to do, it’s good business. Although this type of model would require clients to invest 30-50 percent more in primary care than with a typical health plan, the return on that investment is 3:1 or more.
With this return on investment in mind, Centivo created a health plan solution that incentivizes better overall care by rewarding primary care providers for doing the right things and practicing team-based care, such as integrating behavioral health care into their practice, keeping patients out of the emergency room, and offering virtual visits. In instances where patients require specialty care, Centivo arms its primary care providers with data to help guide better referrals. It’s a win-win-win: employers can save 15 percent or more compared to traditional insurance models, primary care providers receive higher compensation for their services, and members have a trusted guide who coordinates their health care and helps them achieve better outcomes.
There is no doubt that primary care providers deserve recognition for the important role they play in our health system. But beyond simply acknowledging their valuable guidance, paying them more for delivering high-value care reduces overall health care costs and creates a healthier population. Great primary care also saves employers and their employees money while delivering quality care, which is what the best health plans want for businesses and their employees.
Ashok Subramanian Founder & CEO
Ashok founded Centivo in 2017 after observing the inefficiency in the healthcare system and the pain that has resulted for employers and employees.
