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The PCDC Model

A Model for Public and Private Investment in Primary Care

As the importance of primary care in health care reform grows, an actionable, affordable strategy for primary care development will be needed. PCDC offers a highly successful model for expanding and improving primary care for the underserved that brings together strategic partners and uses public resources to leverage private investment.

Investing in underserved communities. PCDC's programs have created an investment of $260 million for 91 health center projects. This investment has generated more than 2,300 jobs (4,600 with multipliers), transformed 630,000 square feet of space, and increased capacity to accommodate 1.75 million additional medical visits.

Successfully mobilizing private investment. PCDC has leveraged nearly five times as much outside capital as it has received in government funding.

Strengthening primary care operations. PCDC has helped more than 400 health center teams at 175 organizations build sustainable businesses that expand access and deliver high-quality, patient-centered care in underserved communities.

Implementing a Successful Primary Care Development Model

Scaling up primary care capacity is critical to healthcare reform. A successful primary care development model must be sustainable and replicable, and must bring public and private resources to bear in support of local, state, and federal health care priorities that depend on increased access to primary care. It needs:

A Major Stakeholder with a deep interest in primary care, able to convene important players and willing to provide or raise start-up money for capital and operations. This could be a locality, a state, the federal government, a large foundation or combinations of these.

Primary Care Providers (health centers, hospitals, private practitioners) that see expansion opportunities but lack access to necessary capital.

Private Investors including tax exempt bond issuers, pension systems, and banks with federal Community Reinvestment Act (CRA), requirement- all of whom seek responsible investment in low-income communities.

An Independent, Accountable Non-Profit Administering Organization to establish and coordinate relationships between the other major players, understand the market, underwrite, approve, and service loans, and provide advice and assistance as needed to improve health center performance.

Benefits of a Primary Care Development Model

The PCDC model is unique because it heavily leverages private investment, as well as public resources, so that no single party bears the full cost of development. To date, PCDC's investment leverages private to public funding by a ratio of six to one.

Additionally, the PCDC model is an investment model, rather than a spending model. Therefore, private monies are borrowed and returned, with interest, to the lender, imposing a business discipline, and requiring professionalism and accountability by all parties. It also offers a natural structure upon which to build and deliver programs that improve business, care delivery, and clinical improvements.

This model is replicable to serve a variety of providers and works effectively with hospitals, community health centers, or private practices, and as a result builds a strong sense of community and commitment to the primary care sector across all provider settings.