Advanced Primary Care and Direct Primary Care
The Alliance combines Advanced Primary Care and Direct Primary Care to help our employer-members improve their employees’ health care outcomes.
What are the Benefits of The Alliance’s Direct Primary Care Offering?
Employer Benefits
Lowers overall health care costs by referring to high-value specialists only when care can’t be provided at the clinic – producing fewer referrals, tests, and procedures.
Creates a predictable payment schedule based on per-month, per-member fee.
Improves the health of employees through comprehensive, personalized, and more convenient care that also enhances employee satisfaction.
Employee Benefits
Lower out-of-pocket costs because care is paid for using a per-employee per-month basis – usually covered by their employer – and more care is kept at the clinic instead of being sent out to costly specialists.
Convenient access for employees with a location at or near their employer with same-day appointments and availability outside of typical clinic hours of operation.
High-quality care that treats the person, not the disease. Our clinics emphasize the length and frequency of contact between a patient and primary doctor to ensure there is more time to treat the whole person, not just the symptoms that prompted them to seek care.
What is Primary Care?
Primary care is the care delivered by clinicians who are trained in family medicine, internal medicine, and pediatrics. These doctors, nurses, and other primary care staff represent the frontline of medicine by focusing on preventative care. They are in the best position to help patients maintain and improve health, detect, and treat problems early, manage chronic conditions when they occur, and refer patients to the right specialists when needed.
Primary care has a significant impact on patients’ health and the cost of their health care. That impact can vary based on how much time doctors and other caregivers are able to spend with patients, what kind of services they deliver at the primary care office, and where they send people for additional care. Since primary care is typically where an individual’s health care journey begins, it’s an effective place to improve the value of health care.
What is Direct Primary Care?
Direct Primary Care is a type of primary care that’s provided directly to employers or consumers and is independent of a larger hospital system. This type of care utilizes an alternate payment method, most often capitated with a monthly cost. This greatly improves access to high-quality care with a flat, affordable membership fee. Direct Primary Care is almost always accessed through an on-site, near-site, or shared-site clinic.
What is Advanced Primary Care?
Advanced Primary Care is an elevated standard of primary care that’s measured by improved health outcomes for patients, lowered total health spend for employers and employees, and achievement of higher levels of patient satisfaction and activation.
Advanced Primary Care focuses on quality of care and outcomes as opposed to patient volume. This means physicians dedicate more time to each patient, ensure chronic conditions are being managed, and can better coordinate care.
The Alliance’s Advanced Primary Care offering meets the following benchmarks:
Enhanced Access for Patients
- More physician-patient time to allow sufficient time to treat the whole patient.
- A greater range of services, including close collaboration with other practitioners such as behavioral health and PT. It can also include access to x-rays, labs, and prescriptions.
- Timely access to care, including same-day appointments, and availability outside of clinic operation hours.
Evidence-Based Medicine
- Care teams provide tests and treatments based on scientific evidence, avoiding unnecessary care.
- Use of standing orders and protocols for patients with chronic diseases to ensure evidence-based care is reliably delivered.
Risk-Stratified Care Management
- Patient risk is assessed, and a care plan is developed based on their unique needs, such as extended office visits, care manager guidance, monitoring and tracking, phone check-ups, etc.
Care Coordination
- A primary care team that engages in outreach, including chronic condition management; coordination of care; and ensuring patient understanding of medications, orders, adherence expectations, etc.
Care Navigation and Referral Management
- A careful selection of high-value clinicians and facilities to those specialists that can’t be provided at the clinic. The clinic team remains in constant contact with this narrow list of trusted clinicians as treatment plans develop.
Organizational Infrastructure
- Analytical and reporting capabilities to allow employers and providers access to data for informed decision-making, as well as continuous staff improvement and training.
Behavioral Health Integration
- Care teams using patient records to identify those who may need outreach and assess behavioral health needs through multiple methods of connection.
Balanced Compensation
- Rewarding care management team based on quality of care – care quality, patient experience, resource use and referrals – not volume of care. This global payment methodology differs from traditional primary care, which uses fee-for-service payments and third-party payer
Hear what Advanced Primary Care Means to our Members
Featured Insights on High-Value Health Care
5 Recommendations for Public Employers from a Self-Insured School District
The Alliance recently sat down with Michelle Golden, Executive Director of Human Resources and Public Relations at the Chippewa Falls Area Unified School District, to ask what advice she would offer public employers that are making changes to their health benefits....
The Importance of Better Healthcare Data for Better Benefit Decisions
Does wading through data seem overwhelming or exhausting? The Alliance hosted a panel of experienced benefits professionals who said they used to feel this way – until they saw the immense opportunities better healthcare data could provide to make better benefits...
Are Out-of-Pocket Costs A Barrier to Care?
Consumer out-of-pocket spending on healthcare was projected to hit almost $500 billion in 2021 – and is expected to reach nearly $800 billion in 2026, according to healthcare market research group Kalorama Information. “Salary growth will continue to lag healthcare...
Want to learn more about The Alliance and Advanced Primary Care?
