Redefining Primary Care In The Value-Based Era

The shift from fee-for-service to value-based care comes at a critical time. For nearly 50 years, primary care providers (PCPs) have faced mounting pressure under managed care, often without adequate support or fair compensation. Today’s models offer a better path forward, positioning PCPs as conductors of patient care and equipping them with the tools and incentives to thrive.  

How Fee-For-Service Left PCPs Behind

For decades, PCPs worked within a fee-for-service model that prioritized volume over comprehensive, high-quality care. The system rewarded frequent procedures and tests while overlooking prevention, impactful quality measures, and long-term outcomes.* This led to an increase in physician burnout, which was often driven by high patient loads, repetitive paperwork, and insurance reimbursement complexities.

A Smarter Approach To Care

Value-based care represents a fundamental shift in how primary care is delivered and reimbursed. The model incentivizes PCPs to focus on health outcomes, chronic disease management, and patient engagement and adherence, shifting their focus from high-volume transactional care to data-driven decision-making.†

Value-based care also extends beyond the exam room. Many entities offer PCP practices additional services, such as clinical programs, like Chronic Care Management and Transition of Care Management, as well as training on how to improve CMS quality measures.

Primary Care With A New Purpose

In old HMO models, PCPs often acted as gatekeepers, responsible for managing referrals to specialists when necessary. In a value-based system, primary care physicians (PCPs) have a far more important and central role in patients’ overall care. They serve as team leaders, guiding patients toward better health outcomes.

With greater clinical autonomy (and responsibility), PCPs can design personalized care plans based on medical necessity, empowering patients to take charge of their health with clarity and confidence.

Helping PCPs Thrive Through The Transition

Shifting to value-based care takes time, effort, and a willingness to embrace change. Genuine Health Group supports PCPs every step of the way, offering the resources, expertise, and infrastructure they need to succeed. Genuine Health Group takes a personal “boots-on-the-ground” approach to establish customized game plans tailored to each practice’s needs.

For independent practices, Genuine Health Group’s support also helps preserve autonomy, giving PCPs the tools to remain independent while thriving in a more complex, outcomes-driven environment.

Genuine Health Group provides real-time analytics and expert support to help practices manage care coordination, risk assessments, and administrative complexities. By taking on the operational burden, the organization gives providers more freedom to focus on delivering exceptional care – without adding financial pressure to their practices.

Leadership With A Vision For Primary Care

Roger Rodriguez and Joe Caruncho have spent decades in managed care, working to improve healthcare delivery for patients and physician reimbursement. At the helm of Genuine Health Group – Rodriguez as CEO and Caruncho as Executive Chairman – they bring invaluable expertise and a clear vision for helping primary care providers successfully navigate the transition to value-based care, where quality and outcomes matter more than ever.

Every day, Genuine Health Group proves its point: value-based care is transforming the clinical experience for both patients and providers. Value-based care links provider compensation to the quality and outcome of care, as well as cost efficiency, ultimately working toward boosting the bottom line. Since its inception, Genuine Health Group has helped PCPs generate over $51 million in shared savings across three Accountable Care Organization (ACO) models.          

*Yu, Z.A. and Gorgone, M.B. (2024) “Pay-for-Performance and Value-Based Care,” StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK607995/ (Accessed: 03 June 2025).

†Pearl, R. (2024) “Healthcare’s Cost Crisis: How Primary Care Can Deliver the Savings We Need,” Forbes. Available at: https://www.forbes.com/sites/robertpearl/2024/11/18/healthcares-cost-crisis-how-primary-care-can-deliver-the-savings-we-need/ (Accessed: 06 May 2025).