Why Payers Need Advanced Primary Care

Payers face a significant healthcare challenge. Rising costs, poor experiences, and lack of access mean that they need something new. Something different.  

Advanced primary care is a primary care model that can work alongside health plans to meet challenges head on and provide lower total cost of care, improved quality and experiences, and value-driven referral navigation. Keep reading to learn why payers should be looking into this groundbreaking model of healthcare. 

Advanced primary care models deliver lower costs, improved outcomes, and more accessible care 

Advanced primary care is a value-based, all-around better approach to healthcare. It focuses on whole-person care by incorporating behavioral health, social determinants of health, and more. This approach removes barriers to access to make healthcare easy to use. Healthcare is made easy through sufficient provider staffing, digital and in-person care, and short waits for appointments.  

The resulting combination of quality and convenience gets people engaging more with healthcare in the primary care space. When this happens, especially when routine and preventive care happens regularly, it lowers or avoids costs by catching problems early. This is how a partner focused on value and excellence succeeds in lowering or avoiding costs, improving outcomes, and making primary care convenient. 

Once engaged with advanced primary care, your people will benefit further from referral coordination. Having a trusted provider help them navigate the healthcare world by identifying high-quality, low-cost specialists can be life changing.  

Advanced primary care offers exceptional experiences for your members 

This better approach to primary care doesn’t just benefit you but has benefits for your members. Faced with their own challenges with healthcare, members are in need of impactful support to improve their experiences and reduce costs. Members will be excited to get this support from their health plans. You can support your members in three ways: 

Improving member experience 

Your members likely regard healthcare as a headache-inducing, stressful matter. This makes them use it less and lets minor health problems grow into serious ones. Changing that experience for them is critical.  

Giving multiple access points (such as digital and in-person) and reducing wait times, both for appointments and in the waiting room, can get people in the door. Once there, a model that allows for longer visits and more face time with the doctor gives your members what they need – to be heard and have their needs fully addressed. They’ll be healthier and happier, now and down the road.  

Providing steerage to high-value networks 

Outside of the primary care environment, referral navigation to high-value networks helps your members find quality care from community specialists. As cost and quality can vary drastically for a procedure even within the same region, data-driven steerage is a meaningful resource for members. 

Improving Clinical Outcomes 

As a value-based care model, advanced primary care is focused on providing high-quality care at every level of healthcare. In the primary care space, the focus on value means providers are incentivized to achieve the best health outcomes possible, instead of a high rate of short appointments that always leave something more to address. Longer appointments paired with care that is held to high standards (such as third-party standards like HEDIS and AAAHC accreditation) means that your members get a better kind of primary care.

Advanced primary care saves you money 

We believe advanced primary care will continue to grow in popularity and this approach will bring a noticeable shift to the healthcare landscape. Healthcare that feels easy and impactful encourages your members to engage and stay on top of routine and preventive care, where health issues are prevented or caught early. Prevention and early treatment decrease expensive downstream care like ER and urgent care visits or hospital admissions. Positive experiences will bring members back to their primary care more often. 

Engaged members are healthier members, and healthier members have lower cost of care. 

Engaging a direct healthcare partner to build an advanced primary care solution benefits you and your members in game changing ways. Flexibility combines with quality and convenience to lower total cost of care. Premise Health is here to help health plans figure out how to incorporate this groundbreaking approach to care into their offerings.  

So why wait? Your organizations and its members need a different kind of healthcare. Learn more about how Premise works with health plans to deliver advanced primary care.