A Disappointing Report Card For Primary Care

NOT AN ‘F,’ BUT …  The first report card on the state of the nation’s primary health care is out today, and it’s nothing to brag about.

The report comes in response to a 2021 report by the National Academies of Sciences, Engineering, and Medicine, which called for a scorecard to be developed to monitor — and improve — America’s primary care. Funded by the Milbank Memorial Fund and the Physicians Foundation, two nonprofits working on improving health care, it’s designed to offer baseline data for the federal government and state governments in financing, access, workforce development and research.

The major findings of “The Health of U.S. Primary Care” won’t surprise anyone who tracks the U.S. healthcare system, but they’re nevertheless sobering. Among the key findings:

— The U.S. doesn’t spend enough on primary health care. Average spending for all insurance types declined from 6.2 percent in 2013 to 4.6 percent in 2020, well below other wealthy nations that are members of the Organization for Economic Co-operation Development.

— The U.S. doesn’t have enough primary care physicians. Between 2012 and 2020, only about 20 percent of physicians completing their residencies were practicing primary care two years later. And the availability of primary care physicians varied widely from state to state, the report found. In states like Utah, Ohio and Tennessee, less than 17 percent of doctors entered primary care in 2020, while Alaska, Washington, Idaho and New Mexico saw much higher entry numbers.

— Primary care is not getting better in underserved communities. HRSA has designated medically underserved areas as rural or urban areas with too few primary care providers, high infant mortality, high poverty levels or high elderly populations. As of 2020, there were roughly 56 primary care physicians per 100,000 people in MUAs across the nation compared with nearly 80 physicians in non-MUAs.


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