Small primary care practices play a vital role in the provision of health care in the United States. Nationwide, 45% of providers work in small practices – those with four or fewer providers. Many have been in practice for decades and are regarded as trusted mainstays in their communities and neighborhoods.

In a recent conversation with Anuja Solanki, a senior project manager for Primary Care Development Corporation (PCDC)’s Clinical and Quality Partners, we discuss small practices in today’s health care landscape and learn more about PCDC’s new Small Practice Management Essentials course.

Tell us about small practices in the US – what does a small practice look like?

Small and independent practices remain indispensable to low- and moderate-income urban and rural communities where they provide personalized care that is responsive to the needs of the community. Many are located in high-poverty areas, serving uninsured, underinsured, ‘safety-net’, and low- and moderate-income patients who are covered by government-sponsored health insurance.  Providers and staff in these small practices tend to be racial and/or ethnic minorities, often immigrants who reflect the ethnic and linguistic make-up of the communities they serve.

How do small practices differ from larger practice groups?

Despite numerous stresses on small practices, including market dynamics that have driven consolidation or buy-outs by health systems or other larger entities, studies show that small practices provide high-quality care, a greater level of personalization and responsiveness to patient needs with lower average costs per patient, and fewer hospitalizations, compared to larger practices. Small practices often have a uniquely strong relationship with individual patients and their families, compared to larger practices.

Health care delivery landscapes are constantly evolving. How have small practices been adapting?

Recent demonstration projects show that many small practices are fully capable of working in new ways, such as integrating behavioral health. Yet, they can also struggle to implement new systems that support efficiency.  Running a physician’s practice is complicated and requires sophisticated management of multiple processes, including the revenue cycle, compliance regulations, human resources, health information technology, quality metrics, and quality improvement, and general business processes.

What do these practices need to ensure they can continue to deliver high-quality care?

To fully participate in reform efforts, small practices require additional resources and improved business acumen to navigate complex reimbursement and payment systems. For example, practices must acquire and use health information technology and build the capacity of their staff to manage the technology in order to carry out data reporting requirements, quality improvement activities, and support the provider’s coordination of care for patients with complex conditions.

What is PCDC doing to help small practices achieve success?

PCDC has designed, developed, and is ready to deliver a blended learning Small Practice Management Essentials course for key non-physician staff from small primary care practices. The course will enable small practices to adopt and sustain operational efficiencies and to prepare for participation in practice transformation opportunities and value-based payment systems. It will also enable staff members who participate in our course to acquire and hone the skill set required to work independently in the role of Practice Manager, freeing up clinical providers to focus on patient care.