Primary care is attracting a lot of interest from investors, tech and healthcare operators. That is perhaps not surprising given that, excluding dentistry, the EMEA primary care market is of the order of €150bn. Covid led to a leap in digital and suddenly this somewhat sleepy sector looks ripe for consolidation. Big hospital groups like Fresenius Helios plan to launch cut-price primary care offerings.
Investors have already consolidated primary care in Denmark, Sweden, Finland, Ireland, the UAE, Portugal and Switzerland. In the UK, primary care property has been consolidated. And a lot of groups such as Babylon and Fresenius Helios are experimenting with new models in Africa, where, often, there is a vacuum.
It is not hard to see how to do primary care better. The patient first goes through a symptom checker which may lead to low cost nurse triage with the family doctor left with acute cases, some suggestions for tests from the symptom checker, all on a slick medical record system. All this enables sessions to be clashed to 8-10 minutes,
But there have been plenty of hiccups along the way. Outside of wealthy Switzerland, margins aren’t great. And telehealth groups such as Kry and Babylon have faced strong resistance from existing operators and payors in the UK and Sweden. Pure digital models which enable patients to switch from physical to telehealth hoover up the capitation fees of tech-savvy younger people who want instant access. That risks leaving traditional family doctor practices burdened with elderly frequent flyers. Kry and Babylon have responded by buying up bricks and mortar and winning contracts in the USA where a dysfunctional system hugely incentivises chronic care.
Doctolib, the booking and back office platform, has done better by enabling traditional primary care practices to become more effective.
For policymakers there is also a risk in letting hospital groups acquire primary care seats with the intent of winning more secondary care referrals. Anything which incentivises primary carers to refer patients to acute care will lead to overtreatment, as payors in the UAE and Germany are well aware! And then there is resistance to change from the world’s most powerful profession.
We cover all this and more at HBI 2022, June 20-22, an IN PERSON conference held at the QEII in central London. Relevant sessions include Primary Care PLUS, Unlocking the Potential of Integrated Care Chains, Who will win the Subscription War and Why? and Building Digital Ecosystems.