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Few clinicians enter the primary care field, with primary care investments on the downswing, finding new reports from the American Academy of Family Physicians and the Milbank Memorial Fund.
Research findings show that years of neglect and chronic investment from the healthcare system have left primary care in a position that is increasingly unable to meet patient needs, particularly in rural and other unserved communities. Ta.
The combination of worsening primary care access and illness patients has created a cycle in which patients use more expensive services, such as emergency rooms, raise medical costs and insurance premiums, and reduce affordability and access even further. And overall healthcare costs continue to rise faster than economic indicators, with primary care infrastructure receiving only a small portion of that money.
What is the impact?
Primary care spending was below 5% in 2022, continuing to decline in all payers, with Medicare and Medicaid primary care spending reaching 3.4% and 4.3% in 2022, respectively, since the last scorecard report. It has decreased.
The primary care physician's reimbursement rates are delayed, the authors said. In 2022, primary care physician rebates averaged $259 per visit, compared to $1,092 for gastroenterologists.
This lack of relative revenue limits the ability of practices to provide high quality primary care and impedes the ability of the sector to attract new clinicians, the report found.
Further data highlighted the impact on the workforce. The number of primary care clinicians (PCCs), including physicians, fellow physicians (PAs), and nurses (NPSs), fell from 105.7 per 100,000 in 2021 to 103.8 per 100,000 in 2022. The 100,000 population remained flat at around 67, but the number of advanced care providers per 100,000 primary care population declined slightly (from 38 in 2021 to 37 2022).
The percentage of primary care NPS and PA fell to new lows of 30% and 24.3% in 2022, compared to 34% and 29.7% in 2021. Over 30% of US adults lacked a normal source of care (USC) in 2022. Despite the historically high insurance coverage rates during this period, it is the highest level in 10 years. The proportion of children without USC fell from 13.6% in 2021 to 12.4% in 2022.
At the same time, differences in per capita health residents' growth between primary care and all other specialties are expanding. The percentage of primary care residents remained stagnant at 17 per person between 2020 and 2022, while rates for all other specialties increased from 29 to 30 per person.
In 2022, the percentage of new doctors entering primary care fell to 24.4% (or 19.8% except hospitalists), marking the lowest rate in a decade.
Bigger trends
According to an analysis of Fair Health's 2023 private claims data, people are shifting away from traditional primary care providers, and have fully mentioned primary care between 2016 and 2022.
However, those numbers range from a lowest value of 43% in Tennessee to a lowest value of 16% in Massachusetts, suggesting significant regional variation. Of the providers who provided primary care services at the time, 56% were doctors and 44% were non-medical scientists.
Nursing practitioners constitute the largest share of primary care providers by specialization (27%) followed by family medicine physicians (20%), physicians (18%), and physician assistants (15%). continued. A lower proportion was explained by pediatricians, obstetricians/gynecologists, and others.
People are increasingly turning to telehealth for their primary care needs. In 94%, the majority of patients were satisfied with their experience pursuing virtual primary care, with four in five (79%) saying they allowed them to take care of their health. .
Jeff Lagasse is the editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a publication of HIMSS Media.
