Unlocking Savings and Access: The Power of Advanced Primary Care for Self-Funded Employers
By Melina Kambitsi, Ph.D., Sr Vice President, Business Development & Strategic Marketing
Self-funded employers are looking for innovative strategies to control healthcare costs while improving the health and satisfaction of their employees. One approach gaining traction is advanced primary care (APC). The National Alliance of Healthcare Purchaser Coalitions’ 2024 Pulse of the Purchaser Survey stated 54% of employers are considering adopting an advanced primary care strategy.
APC models focus on providing high-quality, accessible, and proactive care that reduces healthcare costs and enhances patient experience. Continue reading to learn why APC can be a transformative strategy for self-funded employers.
The Rising Costs of Healthcare
Healthcare costs in the United States continue to soar – with an expected increase of 7.8% in 2025. This poses significant challenges for self-funded employers who bear the financial risk of their employees' healthcare expenses. So, cost predictability is more crucial than ever.
Traditional primary care models often exacerbate cost challenges for employers. Short appointment times, reactive care, and limited coordination between providers can lead to unnecessary referrals, diagnostic tests, and hospitalizations. These inefficiencies not only inflate costs but also reduce the quality of care employees receive. Advanced primary care models can help employers reduce their healthcare spending by improving care quality, reducing unnecessary expenses, and promoting employee health.
What Is Advanced Primary Care?
Advanced Primary Care (APC) 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 engagement. APC focuses on quality of care and outcomes as opposed to patient volume. This means physicians can dedicate more time to each patient, ensuring they can effectively manage chronic conditions and coordinate care.
Lower Healthcare Costs
Prioritizing preventive care and referring to preferred-value specialists only when necessary helps reduce unnecessary tests and procedures. With easier access to primary care, employees are less likely to rely on costly emergency services or be hospitalized for preventable conditions. APC also emphasizes early intervention and management of chronic conditions like diabetes and hypertension. With 60% of Americans living with at least one chronic condition and 40% managing two or more, APC programs help lower long-term treatment costs. This also allows employers to better predict and manage healthcare expenses.
Improved Employee Health and Engagement
Comprehensive, personalized, and more convenient care enhances employee satisfaction and encourages employees to take an active role in their health. This improves health outcomes and productivity. Healthier employees mean fewer sick days, better performance, and lower disability or workers’ comp claims. By investing in accessible and effective healthcare, employers create a healthier, more productive workforce while controlling long-term costs.
Direct Primary Care: A Tailored Solution
Direct Primary Care (DPC) offers employers a cost-effective way to provide high-quality primary care healthcare. In a DPC model, employers pay a flat fee per-member per-month (PMPM), also called capitation, for unlimited access to primary care. This model prioritizes accessibility by removing financial barriers like copays and deductibles and fosters a stronger doctor-patient relationship.
Employees benefit from longer appointment times, same-day or next-day visits, and 24/7 access to their primary care provider, leading to better chronic disease management and fewer costly emergency room visits. This proactive approach can improve overall health outcomes, reduce absenteeism, and enhance job satisfaction.
Advanced Primary Care Implementation Strategies for Employers
To successfully adopt an APC or DPC model, self-funded employers should:
- Partner with the Right Providers: Choose APC or DPC providers with a proven track record of delivering high-quality care and cost savings. The Alliance helps employers develop custom provider networks that meet the needs of their business and their employees.
- Engage Employees: Educate employees about the benefits of APC and DPC to drive adoption and utilization. Get strategies to help employees understand and engage with in their benefits here.
- Integrate with Existing Benefits: Ensure seamless integration with other health benefits, such as wellness programs and pharmacy benefits.
- Leverage Data: Use claims data and analytics to identify employee needs and measure the impact of the new care model. The Alliance helps employers make sense of their data with our Smarter HealthSM analysis, a customized data-analytics report that provides deep visibility into where their healthcare dollars are being spent — and where they can save — without compromising the quality of care.
- Monitor and Adjust: Continuously evaluate the program’s performance and adjust as needed to maximize outcomes.
The Future of Healthcare for Self-Funded Employers
As healthcare continues to evolve, self-funded employers must remain agile in their approach to benefit plan design. Advanced primary care and direct primary care help create a shift from reactive, volume-driven healthcare to proactive, value-based care.
Investing in APC is more than just a cost-containment strategy; it’s a commitment to building a healthier, more resilient workforce. For self-funded employers looking to thrive in today’s competitive landscape, these models are a game-changer, delivering value for both the organization and its most important asset: its people.
Reach out to us if you’d like to learn how an advanced primary care strategy can help you lower your healthcare costs for your business and your employees.
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