More than 80% of primary care providers in the U.S. are now employed by hospitals and large corporate entities, creating referral patterns that may not serve members or the employers footing the bill. For self-funded employers who want to guide their workforce toward higher-value, independent care, the challenge has been logistical: how do you contract with thousands of clinics across dozens of geographies without tearing apart your existing plan?
Patrick Nelli, CEO of Aligned Marketplace, joins host David Stewart to unpack how a national overlay marketplace offers one answer, giving geographically dispersed employers access to independent advanced and direct primary care through a single contract. Drawing on a career that spans drug discovery research, healthcare investing, and a decade at Health Catalyst, where he served as President and CFO, Patrick explains how fee-for-service reimbursement and hospital consolidation have strained primary care.
The conversation also covers what advanced primary care looks like in practice, with longer appointments and smaller patient panels at roughly equivalent cost, and why getting members into the right primary care relationship is the foundation for any strong-performing health plan. Patrick closes with his three Cs of engagement (cost, communication, and convenience), a practical framework for helping members actually use the care available to them.
For benefits leaders and consultants, this is a look at how independent primary care can be added alongside an existing plan, without disrupting the network.
Highlights from the episode include:
- Why misaligned incentives, fee-for-service, and hospital consolidation have reshaped primary care
- How advanced primary care models deliver longer appointments and smaller panels at roughly equivalent cost
- How an overlay marketplace enables direct contracting without disrupting the existing network
- The three Cs of engagement: cost, communication, and convenience
- What’s next for Aligned Marketplace and which employers are the right fit
🎧 Listen to the full episode above, or find it on YouTube, Apple Podcasts, Spotify, or your favorite podcast platform.
📄 Read the episode transcript here.