The Changing Face of Primary Care: An Overview


The shortage of primary care physicians (PCPs) in the United States has been a well publicized and well documented issue. However, the solutions to the various issues faced by primary care in the country have been obscure even after the implementation of the Affordable Care Act. The complications in finding the solutions to the challenges faced by primary care stem from factors ranging from policy reform to changing demographics. According to a New England Health Institute report, primary care in the country is facing a crisis due to the shortage of PCPs and the increase in demand for such physicians.

Factors Complicating PCP Tasks

According to a report by the American Medical Association one of the biggest challenges faced by primary care physicians are the increasing number of visits by elderly patients. The report clarifies that the average visit duration has increased due to the fact that an increasing chunk of the total visits by adults to PCPs are elderly patients. The report also specifies numerous factors that complicate the tasks faced by PCPs in the country, such as the need for PCPs to balance acute care and preventive care, the increasing diversity of the population and, the recent changes and expanding choices in drug therapy.

The Impact of Reforms

The Patient Protection and Affordable Care Act has numerous provisions that are applicable to primary care and some of the crucial ones are providing pay-for-performance models, expanding access to primary care services, and models that transition primary care practices away from fee-for-service based reimbursement and toward comprehensive payment or salary-based payment. The Act also lays out financial policies that promote systematic coordination of care by primary care physicians across the full spectrum of specialties and sites of care, such as medical homes, pay-for- performance programs and capitation arrangements. Section 5405 clarifies the Primary Care Extension Program under the Act and provides support and assistance to primary care providers, in order to enable providers to integrate such matters into their practice and to improve community health by working with community-based health connectors.

The Impact of Health IT

The Agency for Healthcare Research and Quality (AHRQ) has released a report which concludes that implementation of health IT measures in relation to primary care work flows have resulted in gains in productivity and patient volumes, and decreases in various practice expenses. Other conclusions include a need for emphasis on relationships with software vendors, and a need for financial alignment between those stakeholders paying for EHRs and those receiving potential benefits.

In light of the many challenges faced by PCPs and the need for integration of this new primary care system, a holistic and professional approach towards the various aspects of primary care is required for avoiding complications stemming from the various challenges discussed above. The integration in the form of better revenue cycle management, improved payer interaction, and optimum utilization of Health IT can only be achieved with the assistance of dedicated professionals who are experienced in these fields. For more information about integration of Health IT services, EMR/EHR implementation, better revenue cycle management, efficient payer interaction and medical billing and coding services, please visit, the largest consortium of medical billers and coders in the United States.

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