Primary care is deemed to be very important; primary care doctors provide continuity of care and are the typical first line of contact for patients with any health issue. Good, proactive primary care can help avoid health issues or provide an early intervention that leads to better outcomes and less spending. For being so important, our system undervalues primary care–specialist often make two, three, four or more times as much as primary care doctors. Medicare and Medicaid have taken some steps to rectify this problem, but it hasn’t really made a difference. A large part of the US, particularly in rural areas, has a substantial shortage of primary care resources, leading to long wait times and potentially delayed diagnosis and treatment.
The Health Care Cost Institute issued a report looking at primary care spending, both in employer-sponsored health plans and in Medicare. On average about 4.4% of health care spending is on primary care, a shockingly low proportion. There is some variation across the country, likely tied to how rural an area is and population demographics and health status. Rural areas tend to spend a slightly higher percent, likely due to scarcer availability of other types of health care. A slightly lower percent is spent by Medicare, as the Medicare population is older and has more health needs and more complex ones. (HCCI Report)
Despite the supposed importance attached to good primary care, we are not doing enough to attract providers to it or to compensate them adequately.
