Let’s invest in Primary Care in North Carolina.

Family Medicine is Critical for Improving Quality and Lowering Healthcare Costs.

Footnotes:

  1. The Commonwealth Fund, “Health Reform & You – Primary Care: Our First Line of Defense.” 12 June 2013.

  2. Macinko, J, B Starfield and L. Shi.  “Quantifying the Health benefits of Primary Care Physician Supply in the United States.”  International Journal of  Health Services Research. 2007. Vol. 37, NO. 1:111-126).

  3. Franks, P. and K. Fiscella. 1998. “Primary Care Physicians and Specialists as Personal Physicians.  Health Care Expenditures and Mortality Experience.”  Journal of Family Practice 47:105-9.

  4. Rosenthal, T.  “The Medical Home: The Growing Evidence to Support a New Approach to Primary Care.” Journal of the American Board of Family Medicine.  September-October 2008. Vol 21. No. 5.

  5. Baicker, Katherine and Chandra, Amitabh. “Medicare Spending, the Physician Workforce and Beneficiaries’ Quality of Care.”  Health Affairs Web exclusive w4.184 (7 April 2004: 184-197).

  6. Kravet, Steven J., et al. “Health Care Utilization and the Proportion of Primary Care Physicians.” Amer J Med 121.2 (2008): 142-148.

  7. ”Primary Care Spending in Rhode Island.”  Office of the Health Insurance Commissioner.  September 2012.

  8. Basu, S et al “Association of Primary Care physician Supply with Population Mortality in the United States, 2005-2015,” JAMA Internal Med. 2019;179(4)506-514.

  9. Bazemore, A et al. “Higher Primary Care Physician Continuity is Associated with Lower Costs and Hospitalizations.”  Annals of Family Medicine. Vol. 16, No. 6, November/December 2018.

  10. Bazemore, A et. al. “More Comprehensive Care Among Family Physicians is Associated with Lower Costs and Fewer Hospitalizations.” Annals of Family Medicine. Vol. 13, No. 3.  May/June 2015.

PRIMARY CARE FACTS:

  • Increased access to primary care leads to better health outcomes for patients. Where access to primary care is higher, death rates from cancer, heart disease, and strokes are lower. (1, 2) 

  • On average, adults who have a primary care physician have 33% lower health care costs. (3)

  • Increased primary care access reduces emergency room visits, hospitalizations, and surgeries. (4)

  • Increasing the number of primary care physicians in a state by 1 per 10,000 population, while holding constant the total number of physicians, is associated with a rise in the state’s quality rank of more than 10 places, as well as a reduction in overall Medicare spending of $684 per beneficiary.

  • Increasing primary care physicians reduces Medicare spending by almost $700/per patient. (5)

  • For each one percent increase in primary care physicians, average-sized metropolitan areas experienced a decrease of 503 hospital admissions, 2,968 emergency room visits and 512 surgeries. (6)

  • Increasing the percent of the healthcare dollars spent on primary care reduces overall healthcare costs and improves quality. For example, from 2008-2011, total primary care spend for commercial health insurance members in Rhode Island increased by 23 percent, resulting in a reduction of 18 percent for total medical spending. (7)

  • For every 10 additional primary care physicians per 100,000 population, there is a 51.5 day increase in life expectancy, a 250 percent greater influence on life expectancy than an equivalent increase in specialists. (8)

  • A patient seeing the same primary care physician over time results in lower healthcare costs and fewer hospitalizations.

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Let’s Invest MORE in Primary Care

The time to invest in primary care is now. State-level spending on primary care averages approximately 6% of total healthcare spend.

Investments & Efforts Across the US

States across the country — including North Carolina — are recognizing the benefits of primary care investment. The multi-stakeholder Primary Care Collaborative is tracking this activity. We must continue.

Primary Care Around the World

The benefits of primary care investment have long been recognized in health systems around the world. It’s time to recognize the same in North Carolina.