What advanced primary care is, and why it matters to employers
Advanced Primary Care (APC) is a more comprehensive approach to primary care that emphasizes timely access, stronger doctor-patient relationships, prevention, chronic condition management, and coordinated care.
For employers, advanced primary care offers an opportunity to improve employee health, support more effective healthcare decisions, and address underlying drivers of healthcare spending.
For employers, advanced primary care offers an opportunity to improve employee health, support more effective healthcare decisions, and address underlying drivers of healthcare spending.
How is advanced primary care different from traditional primary care?
Traditional primary care plays an essential role in the healthcare system. But the way many of these practices are structured and reimbursed can limit the time and resources physicians have to provide comprehensive, ongoing care. Advanced primary care is designed to address those limitations by placing greater emphasis on accessibility, continuity, proactive health management, and accountability for outcomes.
Traditional Primary Care
Advanced Primary Care
Wait time
2-12 weeks
Same day/week
Time with doctor
~15 minutes
30-60 minutes
Panel size
2,500-3,000
500-1,000
Referral patterns
Refer in house
To highest-value, independent option
Payments
Fee-for-service
Value-based
Quality
Variable
High (curation and fees at risk)
What are the main benefits of advanced primary care?
Advanced primary care is built around several principles that help physicians take a more active role in managing patients' health.
Stronger doctor-patient relationships
Smaller patient panels and longer appointments give physicians more time to understand patients' medical histories, health risks, and individual needs.These ongoing relationships can help physicians identify changes in health earlier and make more informed care decisions.
Proactive, comprehensive care
Rather than waiting for patients to seek care when something goes wrong, advanced primary care emphasizes prevention, outreach, chronic condition management, and support between appointments.The goal is to identify and address health needs before they become more complex or costly.
Better coordination across the healthcare system
Advanced primary care places greater emphasis on coordinating those decisions and helping patients access appropriate, high-quality care.
Incentives align with better outcomes
These arrangements can give physicians greater flexibility to focus on prevention, ongoing care, and improved health outcomes rather than simply increasing visit volume.
Is advanced primary care the same as direct primary care?
The terms Advanced Primary Care (APC) and Direct Primary Care (DPC) are sometimes used interchangeably, and there is no single, universally accepted definition of APC.
At Aligned Marketplace, we define advanced primary care as a more comprehensive approach to primary care that emphasizes timely access, stronger doctor-patient relationships, preventive care, chronic condition management, behavioral health integration, and coordinated care, supported by payment models that tie a significant portion of compensation to value rather than the volume of services delivered.
Direct primary care (DPC) is one practice and payment model that can support advanced primary care. Under DPC, patients or employers pay a recurring membership fee that typically covers most primary care services without additional charges for individual visits.
At Aligned Marketplace, we define advanced primary care as a more comprehensive approach to primary care that emphasizes timely access, stronger doctor-patient relationships, preventive care, chronic condition management, behavioral health integration, and coordinated care, supported by payment models that tie a significant portion of compensation to value rather than the volume of services delivered.
Direct primary care (DPC) is one practice and payment model that can support advanced primary care. Under DPC, patients or employers pay a recurring membership fee that typically covers most primary care services without additional charges for individual visits.
Why does advanced primary care matter to employer healthcare costs?
Primary care represents a relatively small share of overall healthcare spending, but primary care physicians influence decisions that affect much larger costs, including specialist visits, imaging, procedures, and hospital care. For self-insured employers, a more effective primary care model can influence healthcare spending in three important ways.
- Earlier intervention and chronic condition management - Proactive engagement and preventive care help identify health risks, close care gaps, and manage chronic conditions before complications develop.
- More appropriate use of healthcare services - When physicians can address more needs directly, patients may avoid unnecessary specialist visits, diagnostic testing, and emergency care.
- Better decisions about downstream care - When additional care is needed, primary care physicians can help direct patients toward high-quality, cost-effective specialists and facilities, rather than defaulting to higher-cost settings.
What should employers look for in an advanced primary care model?
1. Timely access
Members* can get an appointment within a timeframe that matches the urgency of their need, with practical support to find and schedule care.
*Members are employees and eligible family members enrolled in the employer’s health plan.
2. Continuity with a doctor or care team
Members return to the same doctor or team, building a relationship and a fuller understanding of their health over time.
3. Ability to reach people early
High- and rising-risk members are identified and supported in getting into care before their needs become more complex or costly.
4. Aligned financial incentives
Payment supports appropriate care and ongoing health management.
5. Independent care decisions
Recommendations and referrals reflect the member's needs, with attention to quality, cost and access rather than incentives to keep care within an owned health system.
6. High-quality and comprehensive care
Clinicians can manage a broad range of needs directly and coordinate additional care when appropriate. Employers can evaluate physician quality, patient experience and clinical performance. Together, these factors provide a more useful basis for evaluating primary care than visit counts alone. Where data allows, employers should also examine downstream utilization and total cost of care.
How does advanced primary care fit into existing employer benefits?
Many employers already offer onsite clinics, near-site care, virtual primary care, or traditional primary care through their health plans.
Advanced primary care can complement those investments by strengthening ongoing care and extending access to employees and families who may not be reached by existing programs.
For employers with distributed workforces, this is particularly important. Employees in smaller offices, field locations, retail environments, or remote settings may have limited access to employer-sponsored clinics.
Advanced primary care can complement those investments by strengthening ongoing care and extending access to employees and families who may not be reached by existing programs.
For employers with distributed workforces, this is particularly important. Employees in smaller offices, field locations, retail environments, or remote settings may have limited access to employer-sponsored clinics.
Employers should consider:
- Which employee populations and locations do existing clinics serve?
- Where do employees and family members lack convenient access?
- Can local practices help fill those geographic gaps?
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