Hospitals are doubling down on primary care, but they can’t find enough physicians

U.S. health systems are making primary care a strategic priority, positioning it as the foundation of care delivery, patient experience and cost management, according to Bain & Company’s 2025 Primary Care at Health Systems Survey.

The report, released Tuesday, found that 77% of health executives plan to expand their primary care footprint over the next five to seven years by acquiring or opening new practices and employing more primary care physicians.

“The ambition around primary care is clear: health systems are betting on it as a cornerstone of strategy,” said Erin Morrissette, M.D., partner in Bain & Company’s Healthcare & Life Sciences practice. “Our research shows that can navigate workforce shortages, reimagine care models and adopt AI in ways that truly reduce burdens for clinicians will succeed.”

Long undervalued within health networks, primary care is now being recognized as essential to population health management, cost control and value-based care.

Executives ranked improving clinical outcomes and managing medical costs among their top reasons for expanding primary care. Driving referrals fell to the bottom of the list.

From fee-for-service to value-based models

Although most systems still rely heavily on fee-for-service reimbursement, Bain found growing momentum toward population-based and value-based care. Executives anticipate a notable shift in payment models and clinic design within the next five to seven years, with health systems building out population-focused primary care centers that emphasize preventive care, chronic condition management and patient engagement.

Health systems view primary care as key to both financial sustainability and community impact — an evolution from its historic role as the “front door” of care.

Workforce shortages remain the biggest threats

Despite the optimism surrounding new models, labor remains the greatest constraint. Leaders surveyed ranked physician recruitment and retention as their top near-term priorities and cited ongoing workforce shortages as their biggest concern over the next decade — surpassing even patient experience and financial performance.

The rise of AI vs. the staying power of physicians

Artificial intelligence (AI) and digital tools are scaling quickly to ease physician burden and improve practice efficiency. Health systems expect AI adoption to nearly double across key operational areas in the next three years: e-prescribing systems are projected to grow from 27% to 55%, appointment scheduling from 33% to 63% and telehealth platforms from 38% to 63%.

Patient comfort with AI tools is also on the rise, though unevenly.

In Bain’s companion consumer survey, 60% of patients said they are comfortable with AI listening and taking notes during visits — up from 21% in 2024 — but only 34% are comfortable with AI making a diagnosis, and just 28% with AI serving as their physician.

AI is emerging as a key support tool, rather than a substitute for physicians. Health systems integrating it effectively could help physicians spend more time with patients and less time on administrative tasks.

Looking ahead

As health systems continue to invest in technology and team-based models, Bain’s findings suggest that primary care’s role is expanding beyond coordination to leadership. Those able to balance workforce realities, patient expectations and responsible AI adoption will likely shape the next era of health care.