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Investing in primary care could boost quality and outcomes while slashing costs, but financial and political headwinds stand in the way, experts said at the Aspen Ideas Festival in June.

Why it matters: Profit motives aren't currently aligned for such a model, as evidenced by Walgreens' decision to scale back its investment in primary care subsidiary VillageMD last week.

Commonwealth Fund president Joseph Betancourt, Cityblock Health CEO Toyin Ajayi and Kaiser School of Medicine CEO Mark Schuster spoke on a panel at Aspen Ideas.

How it could work: To allow a primary care-focused model to take hold, panelists emphasized value-based care approaches and a closer investigation of private equity's role in the system.

The big picture: "Primary care is the anchor for prevention, for addressing chronic disease, for addressing disparities," said Betancourt.

"It is well known. The evidence is clear," Betancourt added. "It's not that we don't have the money in the health care system; it's how we deploy it in a smart fashion."

Driving the news: After trying to crack primary care for years, retail giants are retrenching.

Walgreens, which invested more than $6 billion in VillageMD, is electing to close 160 clinics across the country.

Walmart lost nearly a quarter-billion dollars before pulling the plug on its 51 in-store clinics, while Dollar General in May shuttered a pilot with DocGo to bring mobile clinics to rural areas.

What they're saying: "Fundamentally it's a game of 'not me,'" said Betancourt. "Payers say, 'Those hospitals are driving up prices; I have to increase premiums.' Employers say, 'You're increasing premiums.' Hospitals say, 'We need to aggregate; we need more power to negotiate.' Everybody's firing at each other and we're not aligned around getting the health outcomes we need."

Academic medical centers will have to think about contracting differently with commercial insurers and Medicare, said Ajayi. "They have to be willing to make investments in population health, in care coordination, in community-based support."

Academic medical centers also often have large community benefit funds, Ajayi added, and "they need to have concerted strategies in how they invest in the communities around them," Ajayi added.

"The large employers have enormous power if they want to assert it," said Kaiser's Schuster. "As does CMS; they need to assert themselves more with the providers of care, with the insurance companies to really make sure that ... profit does not come at the expense of quality."

What's next: "What is our tolerance for profit absent quality? How do we get the data so we can actually answer the question [and] so we can ask fairly: Are they delivering?" said Cityblock's Ajayi.

Reality check: "Until we can start to get real momentum to shift towards [value-based care], we're going to continue to see a lot of really unfortunate examples where the profit motive doesn't align with with better outcomes or with innovation and investment, particularly in marginalized communities," Ajayi added.

Experts discuss hurdles of getting primary care to profitability

Investing in primary care could boost quality and outcomes while cutting costs, but financial and political headwinds stand in the way.

Panelists speak at the Aspen Ideas Festival. From left: Amazon's Vin Gupta, Cityblock's Toyin Ajayi, Commonwealth's Joseph Betancourt and Kaiser's Mark Schuster.

Panelists speak at the Aspen Ideas Festival. From left: Amazon's Vin Gupta, Commonwealth's Joseph Betancourt, Cityblock's Toyin Ajayi and Kaiser's Mark Schuster. Photo: Aspen Institute/Nick Tininenko

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Investing in primary care could boost quality and outcomes while slashing costs, but financial and political headwinds stand in the way, experts said at the Aspen Ideas Festival in June.Why it matters: Profit motives aren&#x27;t currently aligned for such a model, as evidenced by Walgreens&#x27; decision to <a class="gtmContentClick" data-vars-link-text="scale back its investment" data-vars-click-url="https://www.axios.com/2024/07/01/walgreens-rollback-could-grow-pharmacy-deserts" data-vars-content-id="8859e2ec-29ed-481e-ba51-663551a84c80" data-vars-headline="Experts discuss hurdles of getting primary care to profitability" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2024/07/01/walgreens-rollback-could-grow-pharmacy-deserts" target="_self">scale back its investment</a> in primary care subsidiary VillageMD last week.

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Experts discuss hurdles of getting primary care to profitability

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