New Innovation – Primary Care Models of Care

Innovation meets Reality of Fee for service, re-imaging primary care is quite the challenge…..

Health care is changing and there is a demand to reduce health care spending in the US.  One way health care systems are attempting to reduce healthcare spending is by reducing unnecessary ED and hospital utilizations.  The goal is to provide more preventive care and chronic disease support as well as increasing access to urgent and same day appointments.  One of our challenges is that we have a shortage of primary care physicians and the current models of care are designed for “sick patients”‘ and not “well patients”.   One of our health care system goals are to re-imagine Primary Care using new innovative models to meet the needs for healthcare for our community.  This means introducing new models of care that will encourage population health by incorporating community outreach and preventative care.  The goals of  implementing new models of care is to improve access, reduce total cost of care, increase panel sizes while maintaining quality, satisfaction, and staff and physician engagement and wellbeing.  

One of way of meeting this challenge is to incorporate more innovative models and approaches to primary care such as a team-based approach that will include adding additional staff such as MA’s, RN’s, NP’s, educators, behavior health specialists and pharmacists to the physician office practices and at the same time decrease the need for adding additional physicians.    Another model is virtual health care where care is performed virtually.  We are planning to open a practice of the “future” to incorporate one of these models of care.   It would be great to have feedback from those who may have implemented one of these models of care and hear the successes and the failures. 

The question is how do we implement these new models of care in preparation for tomorrow’s population health model in today’s fee for service model? Is there a team-based model of care that has been tried and proven in your areas where the model has improved access, decreased total cost of care and increased panel sizes to accommodate more members of the community?  Are there other innovative models besides team based care that should be implemented?


As we embark on this journey, it would be great to learn from others and to share our learning as well.


Repositioning a 100 bed secondary care hospital into a 300 bed Tertiary care Hosptial


Addressing unnecessary emergency department (ED) use

Participant comments on New Innovation – Primary Care Models of Care

  1. Nice to see that these challenges are universal. Primary care models are being more and more considered as the solution for a high qualitz lower cost healthcare system. Yet, as you wrote fewer physicians embark now in primary care. Not that it is the absolute solution but Medical Home or Health Home [Maison de Sante] are one approach to favour not only the team/interpro based concept but to improve the access of the population to them. By making the Health home accountable of the health of a given population [usually defined by a geographic area] bz you may further improve the medical and cost outcomes.

  2. Hi Cynthia

    Ho to eat an elephant? one bite at a time. I think you should start implementation on a small scale, starting by one clinic or one specialty, make it your pilot, learn from it and then scale up.

    good luck

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