Reduced investment in primary care is causing Americans’ life expectancy to stagnate or decline. New report shows:. The 2024 Scorecard report also shows that the failure to devote more funding to primary care is creating health disparities in both primary and preventive care.
Six words, “No one is available right now,” can mean delays of weeks or more for patients of all ages trying to schedule an appointment with their primary care physician or pediatrician. Such delays will worsen the situation and increase costs, the report found.
The 2024 Scorecard for the U.S. Primary Care System, released on February 28, is based on three organizations ( Milbank Memorial Fund, Doctors Foundation and the American Academy of Family Physicians. robert graham center) has been published since 2021.
The latest and first scorecard This is in response to a 2021 report from the National Academies of Sciences, Engineering, and Medicine (NASEM).
the report It was a call to action for federal and state governments, health care providers, health insurance companies, and other payers to strengthen the nation’s primary care system. This will primarily be achieved by increasing funding to train primary care clinicians, including physicians, internists, internal medicine specialists, family physicians, obstetricians and gynecologists, and pediatricians.
These physicians work closely with physician assistants (PAs), nurse practitioners (NPs), and midwives, all of whom provide primary care under the physician’s supervision.
Covers primary care in each state
For medical journalists, he said the latest scorecard could be a roadmap for covering primary care in each state. Dr. Yalda Jabbarpour, lead author of the study and director of the Robert Graham Center for Policy Research. As a practicing physician, Mr. Jabarpour sees patients at MedStar’s Georgetown University Hospital in Washington, DC.
On March 12, Felice J. Fryer, a health care correspondent in The Boston Globe, spoke with interviews with one patient, two primary care physicians, and one pediatrician. Explain the problem thoroughly. One PCP, Dr. Vicki Noble, left her private practice to avoid the administrative work required by health insurance companies and the data entry required for electronic health records, two of the issues highlighted by Milbank’s scorecard. He told Fryer that he started working at a Veterans Administration clinic.
The scorecard itself displays national averages and other national-level data showing funding, access, training, and research data for each state.
“Different states are doing things differently, because some states are doing it right and others are far behind national standards,” Jabarpour said in an interview.
For example, 2021 data shows that the two states that performed best on key metrics reported in the scorecard were Idaho and Alaska. According to the latest scorecard, these two states rank first and second, respectively, in terms of having the highest percentage of the workforce devoted to primary care physicians.
In Idaho, 38.2% of clinicians work in primary care, compared to 28.6% nationally, according to the report. Alaska ranked second at 36.2% and first as the state with the most primary care clinicians (meaning physicians, PAs, and NPs) working in the most disadvantaged areas.
social deprivation index
To address the social determinants of health, the Robert Graham Center aims to quantify levels of disadvantage in small areas, assess associations with health outcomes, and develop social developed the Social Deprivation Index (SDI).
Graham Center researchers collaborated with other experts to develop the scales incorporated into the SDI, The study was published in a 2013 paper in the journal Health Services Research..
This measure of social deprivation, when combined with other indicators, could help researchers identify areas that need additional medical resources, the Graham Center said. Speaking to journalists, Jabarpour explained that the latest scorecard shows areas of social deprivation at postcode and block level.
Other top-performing states include Oregon, which ranked highest in overall primary care spending in 2021, accounting for 7.7% of all health care spending, according to the report. (The national average is 4.7%).
Oregon also ranked highest in primary care spending for private health insurers (9.1%) and Medicaid (9.2%), compared to national averages of 5.6% and 4.7%, respectively, the report noted. There is. Oregon’s Medicare spending on primary care at 7.3% is slightly lower than other payers, but still higher than the national average of 3.9%, the report added.
North Dakota has the highest annual rate of new physicians entering primary care among states (36.4%), higher than the national average of 21.6%, the report said.
In North Dakota, the proportion of physicians, PAs, and NPs working in primary care is also high at 26.6%, 44.2%, and 39.4%, respectively. These rates are similar to or higher than national averages of 26.6% for PCPs, 29.7% for PAs, and 34% for NPs.
5 reasons to be concerned
In the report, the three organizations cited five reasons why many Americans lack access to primary care:
- The primary care workforce is not growing fast enough to meet the needs of the population.
- Too few residents continue on a professional path to primary care, and too few receive community-based training.
- The United States continues to underinvest in primary care.
- Technology (meaning electronic health record systems) is a burden in primary care.
- There is a lack of research to identify, implement, and track new care delivery and payment models.
Without further funding, the country’s primary care system remains weak and under-resourced, even though primary care physicians account for 35% of all medical visits, according to the 2021 NASEM report. are doing. Despite this high visitation rate, primary care providers only receive about 5% of health care costs, his 2021 report found.
“Additionally, the foundations are crumbling: primary care clinician visits are declining, talent pipelines are shrinking, and clinicians are choosing to specialize in more lucrative areas of health care.” The book says:
When patients do not have access to high-quality primary care, mild health problems can become chronic illnesses, care management becomes more difficult and there is a lack of coordination, emergency department visits increase, and prevention Care will be delayed and health costs will rise to unsustainable levels, NASEM said.
“People in countries and health systems with high-quality primary care enjoy better health outcomes and more health equity.” Read the 2021 report press release.
