The Evolving Landscape of Primary Care: What Physicians Need to Know by 2030
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The U.S. primary care market is on the verge of significant transformation, with nontraditional providers projected to represent 30% of the market by 2030, according to Bain & Company's most recent report. As traditional fee-for-service models face growing challenges, new players, including payer-owned practices, advanced primary care (APC) providers, and value-based care enablers, are rapidly gaining ground. Payer-owned providers, such as UnitedHealth Group's Optum and Humana's CenterWell, are set to capture 20% of the market, leveraging advanced care management and navigation capabilities to address complex patient needs effectively. Meanwhile, APC providers, particularly those focused on senior care, continue to scale despite regulatory headwinds, demonstrating the ability to improve clinical outcomes while managing costs.
Retailers like Walmart and Walgreens, once seen as key disruptors, have struggled to deliver comprehensive primary care, with many scaling back operations. Consumer trust in retail clinics remains limited, with less than one-third willing to seek care beyond basic services like vaccinations. These challenges underscore the complexities of blending retail and healthcare delivery models. At the same time, value-based care enablers, such as Aledade and Privia Health, are rising in prominence, helping traditional providers transition to more sustainable payment models. These partnerships are expected to double their market share to 10% by 2030 due to their ability to reduce costs and enhance care quality.
Traditional health systems face increasing pressure to innovate or risk losing ground. Many are exploring new strategies, from becoming preferred specialty providers for risk-taking primary care groups to developing innovative care models tailored to specific populations. As the landscape evolves, success will hinge on adaptability, creativity, and a focus on delivering high-quality, value-based care. Physicians must stay informed and proactive to thrive in this rapidly changing environment.
The Future of Primary Care: Traditional and Nontraditional Models Continue to Evolve (Ney, MD, Brookshire, & Pinto Basto, Bain, 12/24).
