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I firmly believe that purely independent primary care will be extinct in five years. This means you won't find a physician in any market who isn't affiliated or contracted with some organization. It will become unsustainable for small practices, those with one to five doctors, to operate independently because they can't negotiate fee-for-service contracts effectively. No payer is going to increase their fee-for-service rates; they're only going to pay differently, which is through value-based care.
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