Hospitals face fiercer competition for the worst-paying specialty

Primary care physicians are the gateway to more expensive specialists, and health systems face intensifying  competition for them thanks to insurers, retailers, investment firms and tech start-ups, Bloomberg reports. 

Primary care specialties including pediatrics, family medicine and internal medicine are among the lowest-paying in medicine, yet these specialties wield great influence over healthcare costs. For every $1 invested in primary care, $13 is saved in downstream costs, Oregon found in an evaluation of its primary care home program. 

"If you're going to ultimately solve the cost crisis, we have to do a better job of taking care of people with chronic disease," Tim Barry, CEO of VillageMD, told Bloomberg. The venture-backed company serves 1.6 million patients in more than 250 locations. 

Competition for primary care physicians is fueled by greater demand from companies not classified as hospitals, but also a tightening supply of these physicians. The pandemic brought on financial stress for independent practices, with some physicians seeking early retirement. About 7 in 10 American physicians worked for health systems or corporate owners at the start of 2021, up from 6 in 10 in 2019. 

"It really is about moving the center of gravity, from patients being managed by hospital systems to really being managed by primary care doctors," Annie Lamont, co-founder of venture firm Oak HC/FT, told Bloomberg. Oak HC/FT has invested in primary care startups such as One Medical and VillageMD, which are two of several primary care companies with big money behind them.

A few takeaways on non-hospitals' primary care footprints: 

  • UnitedHealth's Optum unit now has more than 60,000 employed or "aligned" physicians, with about half in primary care.
  • CVS Health, parent of insurer Aetna, plans to put doctors in up to 350 of its retail stores.
  • Humana plans to open 26 more CenterWell clinics this year, bringing primary care to about 250 locations, with plans to add 30 to 50 more annually.
  • Walgreens plans to install physician clinics in 1,000 of its stores by 2027 through its partnership with VillageMD.

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