Why Relational Care Requires a New Payment Model

It is urgent to change the revenue cycle and payment model for primary care and other relational care providers because the current reimbursement structure works against what all stakeholders want. Providers enter medicine to connect with and serve people. Patients come seeking connection and personalized, whole-person care. When payment models do not allow reimbursement for the time required to build that connection, they undermine what ultimately drives healing: a trusting provider–patient relationship. The best outcomes flow from the strongest relationships, including more targeted diagnoses, fewer unnecessary tests and medications, and better adherence. Longer visits enable this work, yet current reimbursement rewards volume over connection. Codes such as 99205 and 99215 should be financially equivalent to shorter visits, as cramming multiple patients into an hour should not be more lucrative than spending meaningful time with one or two. Evidence shows that investing in relationship-based care reduces total cost of care and lowers year-over-year trend. This approach also supports physician well-being, as research links lack of connection to higher burnout and suicidal ideation among physicians, reinforcing the need to build markets that support relational care rather than revenue-driven care models (West et al., 2025).

West, C. P., Dyrbye, L. N., Sinsky, C. A., Trockel, M., Tutty, M., Satele, D., Carlasare, L. E., & Shanafelt, T. D. (2025). Social isolation and burnout, professional fulfillment, and suicidal ideation among U.S. physicians. Mayo Clinic Proceedings. https://doi.org/10.1016/j.mayocp.2025.07.025