Advanced Primary Care: What primary care looks like when it’s firing on all cylinders

May 5, 2021 / By L. Gordon Moore, MD

If primary care is the foundation of high performing health systems, Advanced Primary Care (APC) is what primary care looks like when it is fully resourced.

An efficient health care system might apply resources to health promotion and disease prevention as a way to reduce downstream costs. Help a person gain the capacity to manage lifestyle and behavior change and that person is less likely to develop a chronic condition or have that condition worsen to the point they end up in the emergency room or become hospitalized.^[1] 

After funding robust public health so that we can have clean water, air and access to healthy foods, the efficient health system might fund the set of interventions that help people adopt and maintain healthy behaviors, manage the complexities of chronic conditions and coordinate any care needed across the complex health care delivery system.

The work of health promotion and disease progression fits naturally with primary care. Our historic under-funding of primary care plus our financial and quality incentive systems that focus on reactive disease management result in a stressed and distracted primary care work force that does not have the capacity to perform the basic functions of primary care.

Thus, we end up with missed opportunities, higher down-stream costs and unnecessary human suffering. We experience high utilization of expensive interventions that might have been avoided had we invested more than about 5 percent of the health care dollar on primary care (other OECD countries spend about 15 percent on primary care, and yes, their outcomes are better than ours).^[2]

We can turn this around. We can shift health care financing away from the destructive influences of fee-for-service, we can focus more on measures that matter and we can support primary care’s transition to Advanced Primary Care.^[3]

On 3M’s Inside Angle podcast, Dr. Wayne Jonas describes the APC model and why we so urgently need it to get the care we want and need at costs we can afford.

Dr. Gordon Moore is Senior Medical Director, Clinical Strategy and Value-based Care for 3M Health Information Systems.

[1] Loef, Martin, and Harald Walach. “The Combined Effects of Healthy Lifestyle Behaviors on All Cause Mortality: A Systematic Review and Meta-Analysis.” Preventive Medicine 55, no. 3 (September 2012): 163–70. https://doi.org/10.1016/j.ypmed.2012.06.017.

[2] Primary Care Collaborative. “PCC’s New Report Sounds Alarm on Low and Declining U.S. Primary Care Spending.” Accessed March 4, 2021. https://www.pcpcc.org/2020/11/24/pccs-new-report-sounds-alarm-low-and-declining-us-primary-care-spending.

[3] Jonas, Wayne B. “A New Model of Care to Return Holism to Family Medicine.” The Journal of Family Practice 69, no. 10 (December 2020): 493–98. https://cdn.mdedge.com/files/s3fs-public/JFP06912493.PDF