The struggles of some primary care physicians

KFF Health News outlined the struggles of some primary care physicians: "primary care providers take on more clinical responsibilities, and for less pay, than most medical specialists." The lower salaries (relative to other specialties) has contributed to a shortage of primary care physicians. However, the article also points out that "primary care providers need time and money to manage or prevent illness ... and their insurance reimbursement rates should take that into account," meaning that declining or even stagnant reimbursement rates from insurance companies can have an outsized impact on primary care providers. The article also highlights why many of primary care physicians are keen to retain their independence, rather than, say, work at a large hospital system or for a practice owned by private equity.

One way that some primary care doctors have reacted is to adopt a business model known as "direct primary care," which "bypasses insurance altogether" (and is therefore less accessible to the average patient). However, some other doctors are banding together in what are known as independent physician associations (IPAs), which gives the doctors "power in numbers when negotiating contracts with Medicaid, Medicare, and private insurance companies." IPAs can also be reimbursed for value-based care where "the medical practice is given a budgeted amount for each patient's care, which provides an incentive to keep them healthy so they need fewer treatments. ... If there is money left at the end of the year, it's split between the practice and the insurer." Many people in the industry have hopes that valued-based care will help slow the growth in healthcare costs.