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The national conversation around primary care — for both the private and public sectors — is experiencing a profound shift towards prioritizing value, prevention and outcomes over wasteful spending. This transformation comes at a critical time. Despite the shortage of providers the U.S. is now facing, investment in primary care saves money and leads to better outcomes by reducing the need for costly treatments down the road.
In fact, recent policy changes are accelerating this shift. With the One Big Beautiful Bill Act signed into law, new opportunities are emerging to enable employers to expand access to direct primary care and telehealth at no cost to the employer’s plan members. The combination of learnings from CMMI and payment models enabled by the One Big Beautiful Bill Act provide a blueprint for how employers can deliver high value healthcare to their plan members.
The unsustainable cost trajectory
Our healthcare system’s misaligned incentives have created a troubling reality for employers and employees alike. Due to factors like Baumol’s cost disease and employers generally being price takers in the healthcare ecosystem, average employer medical trend has and likely will continue to be between 5% and 9% annually for employers operating under the status quo.