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Ready, Risk, Reward: Optimizing Primary Care Model Design to Improve Performance


Primary care is one of the highest priorities for health systems as they move to value-based payment models and take accountability for the health of populations. Leveraging its robust database of detailed physician practice information, Premier® analyzed family medicine and primary care clinics to pinpoint variation across staffing models and identify opportunities for improvement. The analysis found wide variation in staffing models and productivity, as well as opportunities for improvement.

Premier’s analysis found that under fee-for-service payment:

  • Skill mix is not a predictor of provider productivity.
  • Medical assistant-only models may be the most cost-effective option for practices that are fee-for-service revenue based.
  • The highest performing models have a larger number of support staff per provider.

As primary care practices transition to value-based models of care, they will need to methodically layer on staff with richer skill sets that can support a more coordinated model of care. A higher skill mix will be a more cost-effective option in the shift to value-based payment. Providers need access to more meaningful data, a clear understanding of their patient/payer mix and the ability to network with peers to enhance practice model design and effectiveness.

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