In this blog, I am shifting away from my regular focus on diabetes to a broader healthcare topic which became of interest to me after reading a fascinating Washington Post article. The article focused on how people that live in large cities or move to new geographical locations on a regular basis are not developing long-term relationships with Primary Care Providers. In fact the article goes on to explain that many are utilizing Urgent Care Centers for their primary healthcare needs. And if you haven’t already guessed it – Yes, the Millennial Generation is leading this charge! …the “Disrupters of Value Based Healthcare!”
Value-Based System
The overall landscape for healthcare is the process of becoming a truly value based structure which emphasizes a variety of healthcare across the various stages of our life. Access to care is a crucial component of the value based system. Within this structure, the Primary Care Provider is viewed as the reliable medical adviser and coordinator of one’s healthcare needs. Also, Care Managers play an essential role in coordinating individual care for each patient, especially those who require complex levels of care. The Value Based System places a strong emphasis on avoiding high cost containers such as frequent emergency room visits for basic health care, as well as, attempting to avoid any duplicative care services between physicians.
Disruption of the System
At the same time, disrupters within the network of healthcare are creating some challenges for the Value Based System. Consumers no longer feel they are at the mercy of the healthcare system, but rather they can take control and coordinate healthcare themselves. Advances such as telemedicine and patient portals enhance the care possible through a Value Based System. However, another disrupter, is the bust of urgent care centers, whether free standing or within pharmacies. These urgent care centers, if utilized for primary care, have the potential to create fragmentation in the “continuum of care” we find offered within the Value Base System.
Millennials, born between 1981 and 1996, want price transparency, convenience, and immediate care. They are not willing to wait a couple of days to see a primary care provider for an acute illness such as strep throat, flu, or scratched elbow. They have peeled away from the model of office-based primary care which they were accustomed to as a child under the care of a parent’s health insurance! The concern with this shift to an urgent care facility based healthcare plan lies in moving away from a one on one relationship with a Primary Care Provider. This can also fragment an individual’s healthcare and drive up overall healthcare costs.
The Millennial generation is opting for retail clinics within pharmacies or other retail outlets, free standing urgent care centers, and online telemedicine sites. These all allow for convenience, transparency in costs since prices are likely posted, and provide digital connectivity. The Kaiser Family Foundation conducted a survey of 1,200 randomly selected adults and the findings indicated 26 percent of adults surveyed did not have a primary care provider Also, more specifically noteworthy is 45% of 18 – 29-year olds asked did not have primary care provider. While in an Employee Benefit Research Institute 2017 survey – only 33 percent of millennials did not have a regular doctor.
Shifting to Address Disrupters
Primary Care Practices are hearing the Millennials loud and clear! The practices are responding and working diligently to attract and retain patients. How? Digital access has been incorporated allowing for online patient portals with ease in accessing their medical records, contacting their provider and making appointments with greater ease. These practices are adjusting their delivery model to incorporate additional providers, thus allowing for increase in patient capacity, incorporation of walk in patients, and urgent care clinics within many medical practices. The advantage of having the walk in or urgent care clinic within the primary care practice is the variety of care and treating the whole patient.
Reece’s Piece
I view change and adaptions within our healthcare environment to adjust to generational differences as positive. While I am certainly concerned with fragmentation and potential drivers of increase healthcare costs, I am thrilled to see Primary Care Practices transform to provide for the change demanded by Millennials. After all, we have come many light years since the doctor traveled to their patients’ home to provide care. Or have we? Home visit service is commonly offered by larger Primary Care Practices today. Like the rest of life, we come full circle. I encourage we proceed with great caution – we deserve the best healthcare!
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