Design principles - The primary care paradox | KPMG | GLOBAL

Design principles: Management and accountability

Design principles: Management and accountability

The following design principles for primary care are centered on the importance of rigorous governance, accountability for outcomes and standardized processes across care networks and organizations and between providers.


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Organization and management

Primary care has professional and expert management, leadership and organizational support.

To achieve these design principles, new models of primary care will need to be professionally managed. Primary care networks and organizations require expertise in population health needs assessment, information systems, human resource management, process improvement, strategic planning and general management. 

Case in point: Nairn Healthcare Group in Scotland has used organizational development and business management support for over 20 years, and reports this as a critical factor in the development and expansion of the organization and its services.


There is more to do to create standard processes and ways of working in primary care. This is also important so that other providers understand what to expect when care is transferred between providers.

Contract for value

Payers need to move away from contracts that count visits or require large amounts of box ticking and more to using outcomes. The more primary care providers are able to take full responsibility for the care of their populations the more straightforward this becomes.

Rigorous accountability for outcomes, transparent governance are still required. Public confidence in the choices their primary care practitioners make must not be undermined.

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