Dr. Kevin Spencer is Chairman of Premier Family Physicians, based in Austin, Texas, and Chief Clinical Partner for agilon health.
The United States is amid a major demographic shift that is testing the limits of an already strained healthcare system, with Americans living longer and requiring more extensive healthcare services than past generations. Improving access to primary care is a clear way to improve outcomes in our aging population, which is expected to reach nearly 84 million by 2050. Yet, despite this, primary care continues to be deeply undervalued — accounting for just 5% to 7% of total healthcare spending in the U.S.
Meanwhile, primary care physicians are experiencing burnout at record rates in a system that rewards volume of services over quality of care. A newly published study by the American Medical Association found that 63% of physicians reported symptoms of burnout by the end of 2021, and the Association of American Medical Colleges says the U.S. could witness a shortage of up to 48,000 primary care physicians by 2034.
These staggering statistics make one thing clear: If we are going to transform the U.S. healthcare system and meet the needs of our aging population, primary care physicians need a new model that allows them to be the doctors they trained to be and enhance the quality of care for their senior patients.
As a primary care physician practicing for 26 years, I have witnessed firsthand how a value-based model of care can enable and empower physicians to deliver better care. Value-based care is about wellness, rather than illness. It is about prevention, rather than reacting to health crises. It is the key to transforming healthcare in the U.S., enabling better health outcomes, reducing waste, lowering costs and creating more empowered primary care physicians.
Switching to a new model of primary care means thinking differently about how doctors spend their days. My practice, Premier Family Physicians in Austin, Texas, made the switch in 2019 to a value-based care model where we assumed the total cost of our senior patients.
Since then, we have been able to impact their lives in a much more meaningful way. For example, I had a patient with advanced pancreatic cancer who was in hospice care. However, this patient had to keep coming into the hospital for treatment hospice could not provide. Through our value-based care model, we deployed a home care team so that he was able to spend the remaining months of his life at home with his family rather than in the hospital.
A full risk value-based care model allows doctors to invest in the resources and technology needed to guide and coordinate better overall care for their senior patients — including those who are too sick, poor or scared to visit their doctor. Using this new model, doctors can ensure care is patient-centered and seamlessly integrated with payers, while also growing their practices and discovering untapped opportunities for improved outcomes. The result is fewer costly interventions for patients (including less time spent in the hospital or ER), more wellness visits, increased focus on preventative care and more specialized support for patients with chronic or critical conditions.
And it is not just physicians who are taking notice. The CMS and health payers believe the move to value-based care is the number one solution to help manage waste, drive lower healthcare costs and improve outcomes for patients. They even set a goal to transition all Medicare beneficiaries to a total care model by 2030 — an estimated 30 million people. Every stakeholder in the American healthcare system benefits when primary care physicians are empowered to manage the needs of their senior patients. Let’s make it a reality by prioritizing value-based care. We owe it to our seniors and our physicians.
