How to Measure, Improve Strategic Primary Care Investments

July 04, 2022 - Strategic primary care investments—such as investing in sustainable EHR models and moving toward value-based care—can have an impact far beyond primary care services, according to Vivek Garg, MD, chief medical officer for Humana’s Primary Care Organization.

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Pulling examples from personal experience in a primary care practice that had an elective membership fee, Garg shared the distance that a $20 per month fee can go.

The membership fee allowed his practice to expand its capacity, reducing providers’ patient panels from thousands to hundreds and increasing the number and frequency of patient touch points. It went toward care management and incorporating pharmacists, mental health professionals, and social workers into the primary care group’s operations. 

The fee also supported operations, technology, and analytics. The primary care group was better able to track their patients’ care outside of the clinic.

To Garg, this experience—in addition to Humana’s research on value-based care’s impact on primary care spend—formed a strong argument primary care investment. 

“I just looked at what we were able to do for patients, better access, same day visits, more time with your patient, more frequent visits, more onsite services, for the cost of three cups of coffee at Starbucks in a month,” Garg explained. “There's something really inverted or upside down about how we think about things. When you look at value-based care and primary care together, you get these benefits.”

He shared how value-based care models can empower primary care practices to be more adaptable.

“In the pandemic, Humana has shown and other groups have shown that groups that were under robust value-based care payment models very quickly flipped to telehealth and were able to sustain higher rates of telemedicine or virtual care because they were already going there. They weren't bound by the billable encounter in the office,” Garg recalled.

Garg also addressed the role that technology investments play in adding to or detracting from providers’ abilities to serve patients effectively.

“I've yet to see an EMR that you put in front of a practice and clinician, and they say, ‘This is going to radically make my day easier and help me take better care of patients,’” Garg shared. 

“The question is what's the bar going to be? And who is that technology innovation really going to be for? There are some early efforts I've seen that are going in that direction about really being clinician utility, ease-of-use, and impact-oriented. And I would just encourage us to think about how we foster efforts like that so that, ten years from now, we're looking at something radically different and we've made practicing much more sustainable than it is right now.”

He saw EHR transformation as being key to effective primary care. He also explained how robust primary care investment can influence health equity initiatives.

“If you bring more primary care to places that don't have good primary care access, you're probably going to places where there are disparities in care,” Garg said. “The question then becomes how can you care for those patients differently? And I think bringing attention through data and metrics is going to be increasingly important.”