As open enrollment kicks into gear, Premera is leaning into one of the most effective ways to lower the total cost of care: putting primary care front and center. The data is clear, people with an established primary care provider (PCP) stay healthier, avoid costlier care, and have better overall experiences with their health plan. Yet today, 100 million Americans don’t have a PCP, and only 53% of Premera commercial members are connected to one.
Primary care isn’t just the front door to the healthcare system. It’s the foundation for better health outcomes, lower costs, and stronger relationships.
As Romilla Batra, chief medical officer, Clinical Strategy & Solutions, explains:
“At Premera, we’ve seen firsthand that members with an established primary care provider experience improved preventive care, fewer emergency visits, and greater satisfaction with their health plan. When patients have a doctor who knows them, they don’t just get care—they get better.”
Even with clear benefits, major challenges make it harder for people to access primary care:
- Long wait times: The national average wait for a PCP appointment is 26 days—and more than 28+ days in Puget Sound.
- Emergency department overuse: Only 5% of frequent ED visitors saw a PCP in the previous year. Without preventive care, urgent issues become costly crises, driving total cost of care up.
How Premera is elevating primary care
To tackle these challenges, Premera is rolling out a multi-year strategy that puts primary care at the heart of benefit design, partnerships, and member experience.
- Kinwell Primary Care Clinics
Kinwell—available exclusively to Premera and LifeWise members, including Premera employees—offers an advanced primary care model that addresses physical, mental, and preventive health needs in one place. Kinwell makes it easier for patients to get the care they need without unnecessary referrals or long wait times. It enhances the patient experience, creates access, improves health outcomes—and lowers costs.
Nathan Johnson, vice president, Market/Product Solutions, sums it up:
“The best healthcare journeys begin with strong primary care. Our investment in Kinwell reflects our commitment to making advanced primary care more accessible for our members across Washington state. Through this exclusive collaboration, we’re elevating the role of primary care in everything we do—from how we design benefits to how we engage with our customers.”
- Making Talking to Your Doctor Easier
In addition to Kinwell, here’s how we’re making “talk to your doctor” a tangible, affordable action for our members—and driving down costs in the process:
- Smarter Plan Designs: Group plans now offer designated PCP copays as low as $5, compared to $15+ for non-designated PCP visits. Plans position PCP as the central guide for care coordination.
- PCP Auto-Assignment: In some group plans, new members are automatically assigned a PCP to encourage engagement and continuity of care
- Preventive Care Push: Campaigns emphasizing that cancer screenings and other preventive care starts with your PCP.
What’s ahead
We’re continuing to build a primary-care-first future, with upcoming efforts focused on population health, behavioral health integration, and personalized support. That includes:
- Exploring new service areas for Kinwell
- Partnering with fellow Blue plans to expand advanced primary care access
- Offering tiered provider networks based on appropriateness, quality, and cost for a 2027 product, with additional options in 2028
- Giving members the ability to choose their own PCP—on any product—through Premera.com and the Premera app
- Designing new benefit and network models that help members prioritize cost and quality through strong primary care relationships
As we continue strengthening our strategy, the message remains simple and powerful: talking to your doctor is one of the best ways to improve your health—and we’re making it easier than ever.
