Developing an Effective Primary Care Strategy

Engaging your employees with primary care providers leads to health and business gains.

Employees enjoy physical and mental health improvements through preventive care and consistent, coordinated health management. Your organization benefits from a culture of wellness, better employee health and productivity, and reduced medical costs.

Tapping into these gains requires a primary care strategy. An effective approach increases employee access to and usage of primary care. The following considerations can help you implement or enhance your strategy.

Identify your needs and budget

The first step for creating a primary care strategy is understanding your employees’ health needs, challenges and preferences. Employee surveys and health risk assessments can provide valuable insights.

Look for barriers such as affordability, gaps in care or coverage, limited provider options, transportation challenges and caregiving responsibilities.

Tailor your primary care offerings to your employees’ needs. These may include:

  • Coverage for different life stages, such as pregnancy and maternal care, mammograms and colonoscopies
  • Dependent health issues
  • Chronic conditions
  • Demographic health issues related to age, gender or sexuality

Understanding demographic differences is essential. Individuals are more likely to seek care and be satisfied with their care when their providers have similar backgrounds and characteristics, reports HR Executive. Finding a provider of a similar race or ethnicity can reduce visits to the emergency room and overall health care costs.

Once you understand your employees’ needs, explore solutions that fit your budget. Options for primary care services include:

  • Traditional fee-for-service community primary care providers
  • Direct primary care with a monthly or annual fee
  • Virtual primary care
  • Retail clinics
  • On-site or near-site clinics

Work with your benefits adviser to understand each option’s services and potential savings. In some cases, such as community primary care and virtual options, you may want to combine solutions.

Select providers

High-quality providers are essential to your primary care strategy. Consider providers’ medical qualifications and experiences. Examine their costs against the services and value they provide. Examine their ability to match your workforce’s needs from a preventive care, managed health and diversity standpoint.

You may also choose to form partnerships with local clinics. Many employers develop relationships with primary care providers who have a track record of meeting organizational health goals.

Expanding provider selection is typically better than reducing options. Disrupting established relationships with primary care providers can undermine your strategy. Employees who lose access to a trusted primary care provider may delay finding a new one, leading to worse health outcomes.

Ensure access

Primary care access is another critical factor. Work with providers who have multiple locations and offer flexible appointment times and days. Consider telemedicine if your employees work remotely or are dispersed throughout geographic areas. Virtual options can expand the diversity of your providers. If your budget allows, on-site or near-site clinics can increase access and convenience.

An inclusive primary care strategy expands access to your entire employee population, including high-risk employees with chronic conditions and mental health challenges. Ensure your in-person and virtual care providers communicate and work together. This integration enhances primary care treatment and avoids duplicate testing or drug prescriptions.

Educate employees on the medical importance and cost savings associated with primary care and preventive services. Regularly communicate how and where to access services. Emphasize the purpose and benefits of your primary care strategy and the role employees play in its success.

Integrate care

Integrate your primary care strategy with other employee benefits, such as your wellness offerings and employee assistance program. Ensure your primary care providers work with your vendor programs related to chronic conditions, family planning, wellness, mental health and other holistic health issues. Patient navigation services can help employees take advantage of health care options that enhance their primary care.

Create incentives

Your primary care strategy hinges on employee usage. Encourage your employees to be part of the solution by incentivizing primary care. Offer wellness perks such as gym memberships or online fitness classes to employees who engage with their primary care providers. Your plan design can also reduce premiums, deductibles or out-of-pocket costs for nonpreventive primary care. (Note: Regulations may preclude this option for high-deductible health plans.)

Monitor and evaluate

An effective primary care strategy requires ongoing evaluation. Create metrics such as provider access, percentage of employees participating in primary care and health outcomes. You can also measure improvements to aggregated, anonymized health data from health risk assessments. Examples include blood pressure, glucose levels, triglycerides, smoking habits and physical activity. Hold vendors accountable for performance guarantees.

Evaluations should also include legal considerations. Work with your legal counsel and benefits adviser to examine compliance with the Affordable Care Act and other federal, state and local health care laws.

Develop your strategy

To further explore primary care solutions, talk to your insurance broker or benefits adviser. They can help you examine your employee and business needs and provide in-depth details to inform your strategy. 

For more information

If you have questions about developing a effective primary care strategy, reach out to our Employee Benefits Consulting Team.

This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem. Please refer to your policy contract for any specific information or questions on applicability of coverage.

Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.

Written content in blog post: Copyright © 2023 Applied Systems, Inc. All rights reserved.