U.S. Primary Care Market by Primary Care Services (Preventive Care, Diagnosis, Management of Chronic Diseases, Treatment of Acute Illness, and Others), by Service Provider (Independent, Institutions, Payer-Owned Primary Care Providers, Retailers, and Ancillary Providers), by Revenue Models (Fee-for-Service, and Fee-for-Value/Value-Based Care (VBC)), and by Patient Demographics (Pediatrics, Adults under 65, and Adults 65+), by Mode of Consultation (In-Person Medical Care, and Digital and Virtual Healthcare Services), and by Source of Payment (Insurance Companies, and Out of Pocket) – The Country Opportunity Analysis and Industry Forecast 2023-2030

Market Definition

The global U.S. Primary Care Market size was valued at USD 345.8 billion in 2022 and is predicted to reach USD 503.17 billion by 2030 with a CAGR of 4.8% from 2023-2030. Primary care encompasses the fundamental healthcare services offered to individuals by health care providers. These providers typically serve as their initial point of contact with the healthcare system. The objectives of primary care are to provide accessible, comprehensive, and continuous care, emphasizing preventive measures, early intervention, and the management of common health issues.

Primary care plays a vital role in health promotion, disease prevention, and chronic disease management. It serves as the foundation of the healthcare system, facilitating timely referrals to specialists and coordinating healthcare services across various settings. With its focus on holistic patient well-being and cost-effective care, primary care is instrumental in enhancing overall healthcare quality and accessibility.

Market Dynamics and Trends

The primary care market in the U.S. is witnessing substantial expansion as health insurers and pharmacy companies employ diverse strategies to cater to the aging population's primary care needs. For instance, in February 2023, Consumer Value Stores (CVS) Health, acquired Oak Street Health, a Medicare-focused provider, in a deal valued at USD 10.6 billion. This strategic move enhances CVS Health's value-based primary care offerings, promising improved long-term health outcomes and cost reduction for patients.

Moreover, significant increase in the number of active healthcare providers, especially physicians including internal medicine and child health, in primary care specialties is driving the market growth for the U.S. primary care industry. According to the Association of American Medical Colleges, as of 2022, the primary care specialties of internal medicine, family medicine/general practice, and pediatrics had the highest numbers of active physicians, with 120,342 physicians in internal medicine, 118,641 in family medicine/general practice, and 60,305 in pediatrics.

In addition, the rising prevalence of chronic diseases in the U.S. is fueling demand for primary care services. According to the National Association of Chronic Disease Directors, as of 2022, approximately 60% of adults in the United States have at least one chronic disease. Moreover, around 40% of these adults have multiple chronic conditions (MCC), which increases their chances of developing additional ones as they get older. This growing burden of chronic conditions among citizens is a significant factor driving the demand of the U.S. primary care market.

However, the high cost of healthcare in the U.S. acts as a major restraint for individuals seeking primary care services, particularly those without adequate insurance coverage. This financial barrier is a major factor restraining the growth of the U.S. primary care market.

On the contrary, the transition towards value-based reimbursement models is a pivotal factor for future growth in the primary care sector. These models incentivize healthcare providers to deliver high-quality care with a focus on outcomes rather than the volume of services provided. This shift aligns with the goals of nontraditional players including tech companies, retail giants, or startups who often emphasize efficiency, innovation, and patient satisfaction. This trend in the U.S. primary care market is set to create substantial market opportunities.

Market Segmentations and Scope of the Study

The U.S. primary care market share is segmented on the basis of primary care services, service providers, revenue models and patient demographics, mode of consultation, and source of payment. On the basis of primary care services, the market is divided into preventive care, diagnosis, management of chronic diseases, treatment of acute illness, and others.

On the basis of service provider, the market is classified into independent, institutions, payer-owned primary care providers, retailers, and ancillary providers. On the basis of revenue models, the market is bifurcated into Fee-for-Service, and Fee-for-Value/Value-Based Care (VBC).

Based on patient demographics, the market is categorized into pediatrics, adults under 65, and adults 65+. On the basis of mode of consultation, the market is segmented into in-person medical care, and digital and virtual healthcare services. Based on source of payment, the market is divided into insurance companies, and out of pocket.

Competitive Landscape

The U.S. primary care industry comprises of various market players such as One Medical, Oak Street Health, Walgreens Boots Alliance, VillageMD, UnitedHealth Group, Agilon Health, Privia Health, Aledade, Consumer Value Store (CVS) Health, Walmart, and others. These market players are adopting collaboration strategies across various regions to maintain their dominance in the U.S. primary care market.

For instance, in February 2023, Agilon Health strategically partnered with Family Practice Center (FPC), an independent primary care physician group to transform health care in Pennsylvania. This partnership aims to transition FPC to a full-risk, value-based care model for Medicare patients in Central Pennsylvania. 

Additionally, in October 2021, Walgreens Boots Alliance signed an agreement to invest of USD 1 trillion in VillageMD for the advancement of its strategic position in the delivery of value-based primary care. This collaboration is expected to significantly increase the access to primary care for the underserved urban and rural communities in Walgreens.

Moreover, in January 2021, UnitedHealthcare announced the expansion of the virtual care with local physicians for members enrolled in employer-sponsored plans. The firm also unveiled a new Virtual Primary Care service, which is designed to allow access to medical services with convenience.

KEY BENEFITS

• The report provides a quantitative analysis and estimations of the U.S. primary care market from 2023 to 2030, which assists in identifying the prevailing market opportunities.

• The study comprises a deep dive analysis of the U.S. primary care market, including the current and future trends to depict prevalent investment pockets in the market.

• Information related to key drivers, restraints, and opportunities and their impact on the U.S. primary care market is provided in the report. 

• Competitive analysis of the key players, along with their market share is provided in the report.

• A SWOT analysis and the Porter's Five Forces model is elaborated on in the study.

• Value chain analysis in the market study provides a clear picture of roles of stakeholders.

U.S. PRIMARY CARE MARKET KEY SEGMENTS

By Primary Care Services

• Preventive Care

• Diagnosis

• Management of Chronic Diseases

• Treatment of Acute Illness

• Others 

By Service Providers

• Independent

• Institutions

• Payer-Owned Primary Care Providers

• Retailers

• Ancillary Providers 

By Revenue Models

• Fee-for-Service

• Fee-for-Value/Value-Based Care (VBC)

By Patient Demographics

• Pediatrics

• Adults under 65

• Adults 65+

By Mode of Consultation

• In-Person Medical Care

• Digital and Virtual Healthcare Services

By Source of Payment

• Insurance Companies

• Out of Pocket

REPORT SCOPE AND SEGMENTATION:

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