Hiding in Plain Sight: Advanced Primary Care's Success in Driving Value

Background: Advanced Primary Care (APC) is an underutilized but promising model to address rising healthcare costs and declining primary care access in the United States. APC emphasizes patient engagement, extended appointment times, same-day access, behavioral health integration, lifestyle interventions, and reduced administrative burdens. Methods: We describe two case studies of non-profit institutions in the United States who transitioned to the APC model: Mecklenberg County Government and the Indiana Teamsters Union. Mecklenberg County Government adopted APC in 2019 for its 10,000 self-insured employees and dependents while Indiana Teamsters Union adopted APC in 2014 for its 7,000 members and dependents. Key metrics reported include patient engagement, return on investment (ROI), and annual spending growth. Findings: In Mecklenberg County Government, patient engagement rose from 28% to 72% over five years. APC-engaged members cost 17% less per year than non-engaged members, driven by lower hospital and specialist utilization, with a ROI of 5.1x by year five while containing total health spending growth to 1.5% annually, well below the market trend of 6–8%. For the Indiana Teamsters Union, patient engagement reached 41% by 2023. Over a decade, the plan limited medical claims growth to an annual average of 1.7% and realized a ROI of 2.5x by year three. Conclusion: APC is a novel way to achieve value-based care goals and advance the Quadruple Aim of improving population health, enhancing patient and provider experiences, and reducing costs. Policy makers should consider expanding APC programs to deal with rising costs and limited primary care accessibility in the United States.