The Primary Care Gold Rush

Retailers, payers and startups could capture 30% of primary care market by 2030: report

By Heather LandiAug 2, 2022 12:30pm

Bringing new care and reimbursement models to the market along with a bigger focus on virtual care, these nontraditional players are gaining traction and have the potential to grab as much as a third of the U.S. primary care market by 2030, according to a new report from Bain and Company.

Primary care today continues to be dominated by traditional providers in fee-for-service arrangements. But rising costs, demographic shifts, digital disruption and other factors will continue to alter the primary care landscape which opens up opportunities for new players with different approaches, Bain consultants say in the report.

As we look ahead, rising costs, physician shortages, consumerism and digital disruption will continue putting pressure on traditional healthcare models, paving the way for additional growth of models that promote more efficient care, improved outcomes and reduced total cost.

The transition to value-based care (VBC) has been tougher for traditional providers, which grapple with financial, operational

and administrative hurdles. While some traditional providers have started to engage in VBC, true population-based reimbursement—such as partial- and full-capitation payment models and integrated payer-provider models—represents only around 7% of total healthcare spending today.

Expect to see alternative models squeezing traditional models. Traditional fee-for-service will still be the largest model in 2030, but it stands to lose 15% to 20% of market share as alternative models often provide enhanced patient experiences, better physician experiences and more collaborative team-based care, according to the report. 

Primary care disruptors could capture 30% of market by 2030 (