At the 35th Annual National Symposium for Healthcare Executives in Destin, Florida, Ross Armstrong, a health care expert at Kurt Salmon, led a discussion entitled “Primary Care Strategy in a Population Health Environment,” which focused on redesigning primary care to fit into a population health world.

What insights did you share?

The major challenges associated with redefining primary care are largely related to a reliance on a fee-for-service reimbursement system. But outdated education and training models, minimal use of technology and information, and fragmented models of care are also roadblocks to transformation. As primary care transitions to a value-based care delivery model, organizations will need to address delivery model transformation, technology and analytics, and misaligned payment models.

There is no one-size-fits-all approach to creating alignment between hospitals and primary care physicians, and a single hospital may need to vary the models it uses even among its own various physician groups. The right model depends very much on individual circumstances, and it needs to account for myriad factors including geographic expansion, governance and compensation.

What resonated most with the audience?

Within the broad and complex concept of care model redesign, and its implications for integrating behavioral health and taking on the financial risk of a population, providers are especially concerned with the simple question of who should do what. Primary care roles are evolving quickly. Innovative providers are taking a hard look at staffing to both evolve existing roles and to leverage new or non-traditional care provider roles. What does a new care delivery model mean for the lead physician’s communication with staff and patients? Can the front desk serve an expanded role in proactively determining patient needs? Similarly, there has been considerable interest in how providers are fitting in new care team members, including health coaches, dieticians, care coordinators and behavioral health specialists, who must all be aligned with the care delivery model and understand their role on the continuum if the model is to truly improve value.

What new thinking emerged?

The explosion of health care technology has obviously been changing the ways care is delivered and the ways patients interact with providers and insurers. But beyond that, it’s also creating new equity opportunities. Hospitals and physician groups are increasingly collaborating with, and even investing in, some of the technologies being developed to analyze patient cohorts, track utilization and encourage patient-doctor communication. Emerging health tech developers need to test their products, and there are some interesting discussions going on that could result in new alternative revenue streams for hospitals.