Invest in primary care to cut costs, reduce overuse

More investment in primary care could have substantial benefits for the healthcare system.

One solution to improve the U.S. healthcare system is more investment in primary care, and one state that has enhanced primary care is now seeing the benefits.

Increased access to and use of primary care can reduce readmissions and help cut costs, so embracing it is crucial for improved outcomes, according to Russell S. Phillips, M.D., director of the Center for Primary Care and the William Applebaum Professor of Medicine and Professor of Global Health and Social Medicine at Harvard Medical School, in a blog post from Health Affairs. Despite that, just a fraction of spending in the system is on primary care. 

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Related: Invest in primary care, doctors tell legislators

Rhode Island has made significant investments at the state level to boost its primary care providers, according to the post. Between 2010 and 2015, the state’s initiative has increased spending on primary care from 5% to 10.7%, which includes supplemental per-member-per-month payments for infrastructure and on quality metrics.

As part of this initiative to put more focus on primary care, there has also been a significant increase in the number of patient-centered medical homes available, and 95% of practices have achieved that status, Phillips wrote.

Related: How one practice transformed into a patient-centered medical home

PCMHs have been shown to reduce costs and overuse of healthcare services, and thus far the Rhode Island model has seen those same results. A survey of 100,000 members found that for practices that underwent the transformation, costs decreased by $30 million, fueled by a 16% drop in readmissions and a 30% drop in admissions. That represents a 250% return on investment, according to the blog.

The blog notes, though, that Rhode Island’s model was built within a fee-for-service structure. Future looks at how to invest more heavily in primary care should factor the transition from volume to value into the equation.

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