In the last year, health systems across the country have been implementing innovative primary care models to meet rising demand for appointments and address physician burnout.
Nationally, primary care physician supply is expected to meet 73% of demand by 2037; in rural areas, that figure drops to 68%, a Commonwealth Fund report published Nov. 17 found. Rural areas are feeling the burden of this gap. Around 92% of rural counties are federally designated as primary care health professional shortage areas, meaning they lack a sufficient number of providers relative to community needs. Overall, nearly 43 million people live in rural areas where there is an insufficient supply of primary care providers.
Health systems have been working to meet the demand for care by opening more clinics, integrating more specialty services and offering virtual options.
Telehealth is becoming an increasingly popular service option among systems, though Epic reported that use in primary care has leveled off at about 6% to 7% of patients using virtual options. The report, which looked at 411 million primary care visits between July 2022 and October 2025, found telehealth primary care was utilized most by patients ages 25-39, non-English speakers and those living in metropolitan areas.
To meet the needs of patients, some health systems are taking innovative approaches to the primary care model.
“We can’t expect people to alter their lives to fit into our schedule. We need to alter our schedule to fit into their lives,” MetroHealth President and CEO Christine Alexander-Rager, MD, told Becker’s. “What worked five or 10 years ago doesn’t always fit today’s realities. By stepping back and reexamining how we’re organized, we’re creating a more patient‑centered experience.”
Here are some of the innovative ways systems are changing primary care:
Jefferson Health
Philadelphia-based Jefferson Health launched its virtual primary care program in late 2024 to address a shortage of appointments. Now, the model has become one of the health system’s fastest-growing access points. Each month, 300 to 500 new patients join the program, many of whom did not have a primary care provider previously and present with significant unmet health needs.
The telehealth model is designed to deliver the same longitudinal, relationship-based care as a traditional clinic, but through an entirely virtual format. The program assigns patients to a dedicated physician or advanced practice clinician who manages a full panel of patients in preventive care, chronic disease management and specialist referrals. Clinicians follow the same quality dashboards and population health measures as their in-person colleagues.
Not even two years later, more than 3,200 new patients, or 9%, choose the virtual model. Patients in their 20s, 30s and 40s are more likely to choose virtual care, though the program also attracts older patients as well.
Inova Health System
The Falls Church, Va.-based system is planning to launch an after-hour virtual clinic in early July where providers respond to patient calls all night. The after-hours virtual clinic will operate with a walk-in concept, where patients can call the central number or use MyChart to schedule into the after-hours clinic. They will be triaged by a nurse and then meet with a nurse practitioner or physician assistant over video call to discuss their needs. The clinic will also have a physician backup if a higher level of care is needed.
The clinic will be open 24/7, including holidays. At least 50% of appointments will be scheduled in advance, with the rest open to day-of demand. The system is working to staff the clinic with existing team members, who will be able to work from home while manning the after-hours clinic. On the operations side, the after-hours clinic will be able to take 20 to 40 calls a night, which will help triage patients to the right level of care. This could help cut unnecessary ED visits. But the nighttime hours can also help decompress offices during the day because patients can schedule their follow-ups or handle their low-acuity needs that night, rather than waiting until offices open in the morning.
Alongside the after-hours clinic, Inova is rolling out an advanced primary care program — a Medicare product that reviews patient charts. During downtimes, after-hour clinic staff can do additional work related to patient care, follow-up, chart review and inbox management.
The system is also piloting a shared medical visits approach. Each shared medical visit lasts about 90 minutes and includes one to two dozen patients in the same session. The model is designed for follow-up visits for patients with chronic, stable conditions, such as hypertension, menopause, type 2 diabetes or osteoporosis.
MetroHealth
The Cleveland-based system has expanded hours across many of its clinics in Northeast Ohio. Appointments for routine and same-day care are now available from 7 a.m. to 7 p.m. for pediatric and adult primary care. The system will also open a new 24/7 drive-through pharmacy in June at its outpatient health center, operating on the system’s main campus.
To expand hours, the system closed a handful of its smaller offices in the fall and redeployed those providers to larger sites. So far, patients told the system they appreciate having more options, and the system has seen a steady growth in appointment utilization during
NYU Langone
The New York City-based system began providing on-demand primary care at two of its Manhattan locations in August 2024. The walk-in primary care clinics allow new and existing patients to receive care for a range of common health issues without an appointment. Between one-third and half of patients seen daily are new to the system and leave with a referral to another primary care specialty appointment within NYU Langone. System leaders said the clinics have helped meet the rising demand for care while cutting long wait times to schedule appointments.
Penn Medicine
The Philadelphia-based system implemented a 24/7 virtual care model to manage after-hour patients across 63 primary care practices in Pennsylvania and New Jersey. The model eliminates most on-call duties for physicians by routing after-hours calls to a dedicated virtual team. As of January, the call volume for clinicians has dropped by at least 95%.
The after-hours clinic allows routine patient calls during nights and weekends to be handled by the virtual clinic. This is providing better work-life balance for primary care providers, and provides timely care for minor illnesses, prescription requests and symptom management — all while reducing unnecessary ED visits. System leaders said the model has already helped attract early career physicians to their clinics.
University Hospitals
The Cleveland-based system is growing a model that embeds pharmacists directly into primary care practices. Last year, more than 60 pharmacists worked out of primary care practices. This allows patients to meet directly with pharmacists to discuss their prescriptions after their primary care visit.
Prescriptions are delivered to patients’ homes for free, with the pharmacist following up virtually within several days to ensure proper adherence. When medication costs are an issue, the pharmacy team supports patients with identifying lower-cost alternatives or dosing schedules.
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