At Castlight’s inaugural thought leadership summit, Illuminate: Workforce Health, Reimagined, our very first panel was “Can Data Drive the Future of Primary Care?”
This panel was moderated by OMERS Health Tech Investor Marissa Schlueter and featured the following speakers: Firefly Health President and CEO Fay Rotenberg, Vera Whole Health Chief Medical Officer Dr. Kevin Wang, and Lee Lewis, chief strategy officer and GM of medical solutions at the Health Transformation Alliance.
Primary Care Needs to Change—Here’s How
Our panelists all believe the traditional primary care model isn’t serving anyone well—not patients, not providers, not payers. Here are some of the key changes they believe need to take place.
From Fee-for-Service to Value-Based
The way the system is built right now, providers typically receive payment for every single service they provide, including things like office visits, blood tests, diagnostic imaging, and more. This leads to an emphasis on volume—the more patients seen and the more services rendered, the higher the reimbursement, regardless of what the patient’s health outcomes are.
This model is driving up healthcare costs substantially. And on top of that, it’s also not helping all patients get the right care at the right time. Some need more care, some don’t need as much, and others need completely different care than they received.
Instead, we need to shift to value-based care, a model in which providers are reimbursed based on the quality of care they provide and the outcomes achieved. Ultimately, the goal is to provide the best health outcomes at the lowest cost possible.
From Episodic to Longitudinal
As it stands now, many people only see the doctor for single episodes of care, usually when something is wrong. But a patient’s health started long before and extends far beyond that episode.
In an ideal state, patients and primary care providers would have a longitudinal relationship, one in which the patient is proactive about their health (even when there’s nothing wrong) and the provider has access to a holistic view of the patient’s clinical history.
This value-based approach prioritizes whole-person, continuous care rather than solely treating the symptoms for the current most pressing issue.
From Individual Physicians to Team-Based Care
For primary care to be the true quarterback of patient care, the responsibility can’t all rest on the shoulders of one physician. The future of primary care requires a team-based approach in which patients would have the support of an entire primary care team, including providers such as a physician, a health coach, a nurse practitioner, a behavioral health specialist, a psychiatrist, a patient navigator, and more—all of whom communicate with each other about the patient, their needs, and their care plan.
This would allow the physician to focus on more complex care decisions, health coaches to focus on chronic condition management (e.g., lifestyle habits and behavior change), the behavioral health specialist to focus on mental health, and so forth.
In Order for This to Work, Data Is Key
To achieve the highest value care possible, everyone involved—the primary care team, specialists, digital health point solutions, the patient, and so forth—must have an up-to-date and comprehensive view of the patient’s health. While claims give us important details, they only tell us part of the patient’s whole health. The deeper the data integration, the better.
This would enable all providers to better understand what’s going on with the patient, have critical information at their fingertips at the point of care, and eliminate repetition. The provider shouldn’t have to rely on the patient’s recall, and patients shouldn’t have to repeat their health history over and over again.
To recap, the future of primary care revolves around quality and outcomes, longitudinal relationships, and comprehensive care teams. It won’t be a quick shift, nor will it be easy, but it will lead to higher quality care, a better patient experience, improved health outcomes, and monumental cost savings. That sounds more than worth it.