The Primary Care Operations Playbook: Fix Access, Revenue, and Workforce Before You Automate Anything (Healthcare AI Playbook Series)

The template was set years ago by people who have left. Since then it has been amended forty times by exception, each amendment reasonable on the day, and the result is a schedule nobody designed and nobody can explain. Ask why a slot type exists and the answer is a name rather than a reason.

Most primary care improvement work fails at that layer. The strategy is fine. The population health plan is fine. What is missing is governance of the ordinary operating decisions: who may change a template, how a panel is sized, what the staffing ratio is based on, and how a total cost of care target reaches the person who has fifteen minutes with a patient. Without that, every initiative lands on a chassis that cannot carry it.

This is the foundational volume of the series, and it builds the chassis. It is the book the AI titles assume you already have, and it is deliberately unglamorous: template governance, phase-appropriate expectations, staffing built from work rather than from benchmarks, and a scorecard that a medical group can actually run on.

What this book will not do. It does not offer benchmarks to import, on the view that a borrowed ratio is how a bad decision acquires an evidence base. It makes no financial or clinical claim. It builds the governance underneath the initiatives, which is unglamorous work and is also the reason so many of the initiatives sitting above it keep failing.

What you will be able to do

• Govern the template so changes go through a decision rather than an exception.
• Locate your operation honestly on a phase model, and stop importing practices from a phase you have not reached.
• Cascade a total cost of care target down to decisions a clinic manager can actually make.
• Build staffing from the work that exists rather than from a benchmark ratio borrowed from a different payer mix.
• Run a capacity and access scorecard that survives contact with a medical group board.
• Set the weekly operating rhythm so that the same six questions get asked every week by name.

The frameworks this book builds

• Template governance: who may change what, on what evidence, with what review.
• The phase model: what is appropriate to attempt at each stage of operational maturity, and what will fail if attempted early.
• The TCOC cascade: translating a cost-of-care target into decisions at panel, clinic and encounter level.
• Work-based staffing and the capacity and access scorecard: staffing from measured work, and the small measure set that shows whether it holds.

The companion instruments. Every framework here is published as a working file in the The Primary Care Operations Toolkit: 11 workbooks and documents in Excel and Word, licensed to a single organization, available separately from the Institute. Data validation on the cells you fill, IFERROR on every division, formula cells protected and your cells left open. The book gives you enough to build these yourself. The toolkit exists so that you do not have to.

Written from the operator's chair. Neel Chauhan, MD MBA is a physician-executive whose career spans three national healthcare systems. Quantitative claims carry a named, dated source in the same sentence, or the sentence says where the evidence stops. Composites are labeled as composites. The Healthcare AI Institute accepts no vendor sponsorship, holds no vendor equity and takes no referral fees, which is the only reason a chapter is free to say that a category is not ready. 246 pages, 6 x 9 in.

Who this is for
Health system COOs, medical group executives, FQHC leadership and anyone accountable for how a primary care operation actually runs. Start here if you are new to the series.