May 06, 2025

Primary care is the foundation upon which a high-value health care experience unfolds for individuals and populations.

Despite several competing priorities and challenges, most employers and many of their partners clearly understand the need for a strong primary care infrastructure. It’s a key component that can lead to sustainably improved health outcomes for employees and their families.

There is real progress being made toward the goal of expanding access to and utilization of high quality primary care. For example, virtual primary care modalities are extending meaningful access to primary care for individuals who previously lacked it; this type of care is now an expectation, across all age bands, rather than a “nice to have.” Virtual clinical programs are expanding the scope of what PCPs can address. Advanced primary care models are proliferating, and uptake is increasing. While there are some concerns and hesitation regarding artificial intelligence (AI), the promise of AI to increase the capacity of primary care teams is substantial, with demonstrated improvements happening through use of AI-augmented technology that improves outreach, care coordination and patient experience in the exam room.

For primary care to be an effective bedrock of the health care system and an engine that drives health improvement and cost mitigation, we believe it must be advanced, accessible, affordable and accountable. The following section explains each feature in more detail.

Advanced Primary Care Must Enable Innovation

Given the broad array of patient needs and resource constraints, primary care needs broader adoption of innovation that can augment experience and care effectiveness. Primary care that incorporates this principle is referred to as “advanced” primary care. Many definitions of advanced primary care have been proposed, including from Business Group on Health. Common characteristics include 24/7 access to care whether in-person or virtual, proactive outreach to engage patients in prevention, multidisciplinary care teams (e.g., those that include mental health, nutrition and connections to social services) and data-driven referrals to help PCPs be a patient’s “home” for health care. Past and future innovators and primary care teams themselves have created ways for broader adoption of these capabilities.

In addition, advanced primary care must be effectively integrated with other elements of the health care experience to augment innovations across the industry. In their strategic adoption of programs and contracting across the ecosystem, employers should strongly consider their vendors’ ability to steer employees to advanced primary care providers. Regardless of how innovative a health care strategy or program may be, if it is disconnected from a high-quality primary care experience, it may do more harm than good. Similarly, advanced primary care must be an augmenter and facilitator of the patient experience across the health care system so that innovative technologies, specialty care, “point solutions” and other tools are better able to reach and impact patients. Realizing this goal demands timely, safe and unrestricted data sharing by everyone.

Many patients listen to their doctors in a way that employers and health plans will rarely be able to replicate. Consequently, PCPs are an essential force in helping patients access evidence-based clinical innovations like new pharmaceutical breakthroughs and achieve more precision in recommended cancer screenings. Employers and their partners need to make sure that advanced primary care providers are equipped with the information they need to drive appropriate utilization of such advancements in care.

Many are concerned that PCPs are expected to solve problems beyond their traditional scope that they may be unequipped to handle, including being the first line of defense in the mental health crisis. On the one hand, expectations should be reasonable, but on the other hand, the primary care system needs to advance its capabilities to address issues related to timely access, long wait times and siloed care. Primary care providers must be willing to embrace new technologies and care delivery models to increase their impact on a broader set of conditions.

Primary Care Can’t be a Bedrock if Patients Can’t Access it

People should be able to meaningfully access primary care services in multiple modalities when they need them, delivered by providers that can meet their diverse needs. Despite many massive competing priorities, employers and their partners need to spend time, attention and resources on improving access to high-quality primary care, including access to both virtual and in-person care. Achieving this goal may entail choosing direct contracting with primary care providers accountable for quality and access, encompassing those offering on-site and near-site clinic resources.

Employers and their partners must deploy multipronged strategies to increase employee engagement with primary care. This can be done by dedicating resources to communications, plan design incentives and navigation to increase appropriate utilization of primary care. Employers may want to consider curated emerging primary care networks that increase access to value-based care.^1,2 Primary care that is accessible but not accessed isn’t helping anyone.

Providers and vendors must be willing to share data to enable effective care coordination between primary and specialty care providers (including point solutions and other programs employers offers), which in turn drives appropriate utilization of primary care. A primary care practice armed with good data can increase accessibility, enabling longitudinal relationships between the practice and its patients. These relationships can ensure that resources are available to patients when they need them, avoiding long waiting periods that can create poor patient experiences.

Money thoughtfully spent on primary care is money well spent. Research suggests that up to 90% of health care spending is impacted by primary care; effective management of “big ticket items” like specialty drugs and hospital care will be significantly impacted by a patient’s primary care experience.³  Primary care providers are the first line of care encouraging their patients to get preventive screenings, vaccinations and manage their chronic conditions. Similarly, accessible primary care can alleviate patients’ unnecessary utilization of urgent care centers or emergency rooms, which are more expensive and siloed from longitudinal care.

Globally, access to primary care varies significantly based on a host of factors by country, region, public health infrastructure, physician shortages, funding models and others. Many governments see primary care as a responsibility falling squarely into the public health domain. However, many employers are looking to expand access to primary care services themselves through on-site clinics, expansions in coverage for preventive services in private insurance plans and other avenues. Employers should seek opportunities to expand access to primary care in areas across the globe where services are underutilized and broad access is a challenge.

Primary Care Is ’Inexpensive’ Compared to Other Care, but that Doesn’t Mean It’s Affordable

Primary care is “inexpensive” compared to other health care services, especially in the U.S., but surprise bills for preventive care and long wait times create patient concerns about affordability and unexpected costs incurred in fee-for-service (FFS) primary care settings. Employers can and should directly address financial obstacles resulting in primary care access issues for patients. For example, some employers have reduced or eliminated out-of-pocket costs for all primary care visits or specifically those delivered in on-site clinics. Many offered virtual care outside the deductible when permitted by federal regulations. Those federal regulations should be extended and expanded to give employers greater flexibility regarding pre-deductible coverage for preventive care, primary care, on-site clinics and virtual care.

Providers must embrace technologies and willingness to coordinate with other parts of the health care system to increase efficiencies and lower cost. Health plans need to build networks with a robust primary care infrastructure and elevate efficient high-quality primary care providers in their directories so patients can find affordable care more easily.

With Increased Financial Support Must Come Accountability

The predominant FFS reimbursement system for primary care is ineffective for providers, patients and employers. Providers manage increasingly large patient panels. Patients’ access to virtual care and care management resources outside the exam room may be limited because of the per visit FFS reimbursement model. Employers and patients are paying for visits that are too short, too infrequent with the payment amount not at all tied to the outcomes. 

Employers need to promote and adopt value-based approaches in primary care. There are many reimbursement models that do a better job than FFS of holding providers accountable for their patients’ health outcomes, experience with care, accessibility and quality scores.

Value-based approaches also have the potential to give high-performing PCPs (and their clinical teams) a more stable, robust financial model that enables them to fund many services, such as virtual care, technologies and data. In turn, data can enable better population health management, coordination with social services and others that will lead to expanded capacity and improved outcomes.

Conclusion

Primary care is one of the main areas where employers can have a direct impact on cost, access and employees’ health care experience. From prevention to specialist referrals and chronic condition management, effective primary care providers, empowered by aligned financial incentives, actionable data and newer technologies, can be the core of an effective health and well-being strategy. Prioritizing access and affordability of advanced primary care, while holding providers and health plans accountable for results, should be one of the top priorities of employers looking to achieve better health at a lower cost for their population.

Related Resources

• Value-based Primary Care
• What's Needed in Primary Care: Innovation With Integration
• Business Group on Health Calls for Congressional Action on Primary Care Legislation
• Business Group on Health Recommends 7 Action Steps To Speed Health Care Industry’s Move to Value-Based Payment Models
• Business Group on Health Submits Statement on Alternative Coverage Models and Arrangements
• Promoting Competition and Innovation in Health Care Policy Position Statement
• Taking Action on Value: A Business Group on Health Viewpoint
• Taking Action on Health Care Costs: A Business Group on Health Viewpoint

More Topics

Resource Primary Care Value-based Care Preventive Care