Sources of Usual Care

Many changes have occurred in the structure of the physician market, as more doctors are employed and located in large practices or health systems.  A Statistical Brief from the Agency for Healthcare Research & Quality, based on Medical Expenditure Panel Survey data, examines whether these structural changes are affecting where Americans get their medical care.   (AHRQ Brief)    In 2015, around 250 million people, or 80% of the population, reported a usual source of care and 44% of those saw that source at least once during the year.  30% of these people with a usual care source visited a practice with between 4 and 10 physicians and 24.8% visited a solo practice, while 23.2% went to one with 2 to 3 doctors.  So surprisingly, for their usual care source, probably a primary care physician, over three-quarters of Americans still go to relatively small practices.  63% of practices that were used as usual care sources were single specialty, again likely a primary care one.  54.7% of the patients visited practices that were independent, 20% to those owned by a hospital and 17% to a clinic owned by a government or a non-profit.  21% of the practices had at least one nurse practitioner or physician’s assistant and 51% had two or more of these professionals.  More than 90% of the usual care source patients went to a doctor who used an electronic medical record.  An interesting glance at characteristics of where people get their care.