Thursday, January 26, 2012

[EQ] Scenarios for primary care in 2025 and recommendations for working toward a preferred future

Scenarios for primary care in 2025 and recommendations for working toward a preferred future


Project of the Institute for Alternative Futures supported by a grant from the Kresge Foundation


Available online at:



“………Forecasts by numerous health care experts strongly suggest that primary care is likely to be very different from what we experience today. While the recent health care reform legislation is driving change from a policy level, developments in technology, disease knowledge, health care financing, care protocols and modalities, and other areas are transforming the field of primary care.


As these changes unfold, it will be essential for policy-makers, public health officials, health care providers, and others to understand the alternative paths that 21st century primary care could take…..”


Scenario Workshop Toolkit:  In addition to the full report, IAF has developed a scenario toolkit  and
slides   to help organizations,  health care providers, and communities to conduct scenario planning exercises and consider the implications of these Primary Care 2025 Scenarios for their own strategies and operations.

“……Scenarios are different stories describing how the future may unfold. Scenarios force us to consider the systems surrounding our topic and to clarify our assumptions. Given persistent uncertainty, they bound that uncertainty into a limited number of paths. These paths help us think about different probabilities in a larger space of possibilities.

People who work with scenarios find more creative options than those who develop plans based only on the past and present. Strategies, plans, and actions that are created can also be “future tested” against the different scenarios to assure robust initiatives rather than continued efforts based on outdated assumptions. Scenarios are the best method for systematically addressing the uncertain future.

IAF has developed various types of scenarios using the “Aspirational Futures” technique. This technique develops scenarios in three zones:

■ A “zone of conventional expectation” reflecting the extrapolation of known trends, the expectable future;

■ A “zone of growing desperation” which presents a set of plausible challenges that an organization may face, a challenging future; and

■ A “zone of high aspiration,” in which a critical mass of stakeholders pursues visionary strategies and achieves surprising success. (Two scenarios are developed in this zone in order to offer two alternative pathways to surprisingly successful or visionary futures.)………….”



Why Scenarios? 1

Development of the Primary Care 2025 Scenarios

Evolution of Primary Care in the United States

Four Primary Care 2025 Scenarios

SCENARIO 1: “Many Needs, Many Models”

SCENARIO 2: “Lost Decade, Lost Health”

SCENARIO 3: “Primary Care That Works for All”

SCENARIO 4: “I Am My Own Medical Home”

Comparative Matrix

Primary Care 2025 National Workshop

Recommendations and Robust Strategies

Health Professional Education

Individual and Community Capacity and Accountability

Health Information Technology

Population Health

Political and Cultural Change


Appendix 1: Acknowledgements

Appendix 2: Forces Shaping Primary Care




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