Not only are the ranks of primary-care doctors declining, according to the California HealthCare Foundation, but also 25% of the nation's pediatricians, family physicians, geriatricians and internists are 56 or older, so innovations—such as worksite clinics, healthcare teams and telehealth—are required to address future care demands.
According to the new CHF report Primary Care Everywhere: Connecting the Dots Across the Emerging Health Landscape (PDF)
, "As currently organized, financed and delivered, primary care meets neither current nor future demand for services," so new business and delivery models—including shared-savings incentives, retail clinics and self-care at home—are necessary to provide more cost-effective care that meets patients' needs, wants and expectations.
Barriers to innovation listed in the report include poor distribution of primary doctors, insufficient rural access to primary-care physicians, lack of compensation for care coordination or education activities, low levels of patient involvement and poor exchange of information.
The report highlights how organizations such as the Eisenhower Medical Center in Rancho Mirage, Calif.; Pennsylvania's Geisinger Health System; and the WellMed primary care-based accountable care organization in San Antonio, are addressing current issues and serving as models for the future.
The report also looks at the growing role of retail giant Wal-Mart in the healthcare industry and cites several examples of the company's positive influence, among them boosting rural healthcare access, having pharmacists serve as part of the "frontline troops" in treating chronic disease, and the use of self-service health kiosks, retail clinics and nurse-supported telehealth consults.