Understanding trends in primary care utilization is critical in the new health economy, especially given how many people have delayed or foregone care during the pandemic, and the significant downstream effects these delays can have on healthcare costs, patient outcomes and overall burden of disease.
Developing an effective primary care strategy requires knowing where demand is projected to grow and how consumer preferences and health behaviors are influencing its utilization. This is especially important since the proportion of the U.S. population with a dedicated primary care relationship has declined (this was true even before the pandemic). Today, on average, 12% of the population sought healthcare services between 2019-2021 without seeing a primary care physician (PCP) in the same timeframe.
With primary care being the nation’s front door to both general and preventive care, providers must employ data-driven care delivery strategies to remain relevant and competitive. Provider organizations must also have a pulse on primary care utilization and population shifts happening at both the national and local levels to more effectively meet the needs of those they serve.
To illustrate this point, consider what both the national and regional data tells us about primary care demand changes during the pandemic and the projected shifts ahead:
Women drove primary care visits during COVID
When looking nationally, the aggregate utilization of primary care services has yet to return to pre-pandemic volumes, except among one cohort: females ages 20-49. Women in this age group actually increased their utilization of primary care services following the initial pandemic-driven drop (up 7% from October 2019 to October 2021). This data indicates that women are returning to preventive and screening services that may have been delayed by the pandemic.
Another notable care utilization trend is that behavioral health visits among women ages 20-49 have also returned to pre-pandemic levels. And, perhaps unsurprisingly, it was also this same cohort of women, of a specific psychographic profile, that have been primarily responsible for telehealth’s relatively limited use during the pandemic, which they have used largely for behavioral health services.
All this aside, the fact remains that primary care utilization nationwide is still down relative to pre-pandemic levels, and the return to primary care will vary by market.
Healthcare is local: Geographic shifts and increased competition bring opportunities and challenges
There are several factors that influence primary care utilization at the market level, including provider supply, disease burden, and population migration and growth.
For example, “normal” primary care utilization among women ages 20-49 in the greater San Bernardino area of California decreased by over 47% from 2019 to 2021, whereas those in the greater Dallas/Fort Worth area saw increases of nearly 20%.
Looking forward, states in Sunbelt are set to outpace primary care utilization growth in other markets, with five of the fifteen fastest-growing locations being in Florida and Texas: certain areas of each state are projected to see compound annual population growth of more than triple (2.2%) and double (1.7%) that of the average U.S. growth rate (0.7%), respectively, between 2021 and 2029.
States with growing populations will also experience significant changes in the behavioral profiles and preferences of their residents, subsequently influencing consumer behaviors and demand for healthcare services, including primary care.
Beyond market-specific variations, primary care providers must also account for the ever-expanding retail and urgent care market, which stands to disrupt primary care referral patterns, only heightened by waning consumer loyalty in primary care. Retail health centers’ consumer “stickiness,” on the other hand, along with offering competitive prices in markets with a high demand for care, will require PCPs and traditional providers to rethink their care delivery strategies.
A winning primary care strategy
It’s time for primary care providers to better know their audience. Traditional care models are a thing of the past, and the winners in the new health economy will be those that use precise, data-driven insights to both understand and adapt to changing market conditions; those that pay attention to market and geographic-specific trends; and those that rely on predictive analytics to craft targeted strategies that consider changing consumer wants and needs.
Those on the supply-side of the health economy that can both dynamically measure shifts happening across populations and market segments, and subsequently develop targeted strategies to influence primary care choices, will be those that maintain a competitive advantage in the months and years ahead.
Dr. Sanjula Jain, Chief Research Officer and Senior Vice President of Market Strategy at Trilliant Health.