Driving investment in primary care could be the key to higher-value care across the healthcare system, according to a New England Journal of Medicine op-ed. The authors recommend tracking the proportion of medical spending dedicated to primary care as a way to spur smarter investment.
Even as the U.S. turns toward value-based care models, it continues to undervalue primary care, the authors write.
“Greater use of primary care has been associated with lower costs, higher patient satisfaction, fewer hospitalizations and emergency department visits, and lower mortality,” said Christopher F. Koller, president of the population health-focused Milbank Memorial Fund and NewYork-Presbyterian Hospital's Dhruv Khullar, M.D.
On the strength of data indicating patients place a high value on their relationships with primary care physicians and are overwhelmingly satisfied with those relationships, national advocacy groups have pushed for further investment in primary care.
The article cites programs in Rhode Island and Oregon that require payers to report primary care spending.
In Rhode Island, where regulations require insurers to increase primary care spending by a percentage point per year, payers routed money toward services geared toward higher-value care, including accountable care organizations and patient-centered medical homes.
That increased spending yielded lower commercial health insurance spending per capita, while raising the number of primary care physicians per capita compared to the other New England states.
State-run incentive programs also provide a political benefit in that they command bipartisan support, bypassing the more entrenched, tendentious arguments taking place on a national scale.