初级保健，重新构想：现代劳动力和护理模式创新（英）

Appendix Disclaimer These materials reflect general insights based on currently available data and modelingassumptions related to primary care supply and demand. The analyses have not beenindependently verified and are inherently uncertain. Future outcomes may differ materially fromany statements of expectation, forecasts, or projections contained herein. These materials are not a guarantee of results and should not be relied upon as definitiveforecasts. They do not constitute medical, policy, legal, or other regulated advice and do notinclude all information required to determine a specific course of action. The projections andfindings are provided “as is” solely for informational purposes, without any representation orwarranty, and all liability is expressly disclaimed. References to specific data sources, organizations, or external models are included solely forillustration and do not imply endorsement or recommendation. The recipient remains solelyresponsible for all decisions, interpretations, and use of these materials, as well as for ensuringcompliance with applicable laws, regulations, and standards. Model overview This appendix serves as a methodological supplement toMaking care primary again: Howworkforce reform, investment, and new models of care can improve the patient experience,an interactive from the McKinsey Health Institute in collaboration West Health Institute. Theinteractive is designed to estimate current and future primary care capacity in the United States,to highlight potential gaps between the demand for primary care visits and the supply of providercapacity, and to model potential scenarios that address the gap. Demand modeling. The demand section includes two components: selecting condition groups ofinterest (for example, behavioral health [BH], Alzheimer’s disease and other dementias [ADOD],and metabolic health) and calculating total demand. Demand is calculated as the visits fromcurrent diagnosed claimants of primary care plus the estimated number of primary care visitsrequired if 90 percent of adults across the condition groups received the same standard of care.This approach accounts for people who are affected but undiagnosed or untreated, therebycapturing the latent demand not visible in claims. Supply modeling. The supply section includes calculating capacity—as measured through totalpotential primary care visits—by taking the product of the total actively practicing primary careprovider workforce and average provider productivity. The provider workforce includes familymedicine physicians, general internal medicine physicians, geriatrics physicians, nurse practitioners(NPs) in primary care, and physician assistants in primary care. Scenarios. This section includes both demand-side and supply-side scenarios: modeling ofdemand scenarios such as adoption of GLP-1s, disease modifying therapies (DMTs), integratedcare models, and population health improvements and modeling of supply scenarios such asworkforce growth and productivity improvement interventions. The primary care visit gap is calculated as total demand minus supply: A positive value indicatesa shortage (demand exceeds supply), and a negative value indicates potential additional capacityat current care standards of about 30-minute visits (supply exceeds demand). Our model alsoassesses urban and rural demand. However, these models do not account for the many otherfactors that affect how supply meets demand, such as patient preferences, the rise in conciergeprimary care, provider distribution, or logistical barriers to access. This means the practicalassessment of visits, especially in rural areas, may require additional research. Demand modeling A. Selecting condition groups of interestMethodology To focus on a set of relevant conditions, condition groups of interest were selected based onwhich conditions drive a meaningful portion of the demand for primary care for adults in theUnited States, have a high disease burden, and serve as the main areas where transformationalcare models are being developed and implemented. After analyzing conditions through thesefilters, three groups of interest emerged, including the following conditions: —BH (80 million people as of 2025). Primary care is important for detection of BH conditions,inclusive of all mental disorders and substance use disorders. —ADOD (seven million people as of 2025). Primary care is key for early detection of ADOD,which makes up 80 percent of neurological disease cases of older adults. —Metabolic health (96 million people as of 2025). Conditions are included based on highprevalence among older adults, long-term and chronic nature, and relevance to primary care,including obesity, diabetes, hypertension, and heart diseases. Two final groups were created to capture the entire population: “<20” and “rest of population”(ROP). The <20 group includes all individuals under the age of 20, regardless of conditions. ROPincludes all remaining adults tha