Pricing Patients Out of Primary Care
Authors: Kimberly Rask
Journal: Annals of Internal Medicine (2020)

Editorials18 February 2020Pricing Patients Out of Primary CareKimberly Rask, MD, PhDKimberly Rask, MD, PhDEmory University and Alliant Health Group, Atlanta, Georgia (K.R.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-4000 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Primary care has long been known to be an effective tool for improving population health outcomes (1). However, the number of Americans receiving their care from primary care providers (PCPs) has been decreasing. Ganguli and colleagues (2) explore this issue by reporting PCP visit trends between 2008 and 2016 among members aged 18 to 64 years of a large, national, commercial insurer that covers millions of Americans yearly (2).Rates of PCP-billed visits decreased by 24% from 2008 to 2016, and the proportion of adults with no PCP visit increased from 38% to almost half. Specialist visit rates remained essentially ...References1. Institute of Medicine. Primary Care: America's Health in a New Era. Washington, DC: National Academies Pr; 1996. Google Scholar2. Ganguli I, Shi Z, Orav EJ, et al. Declining use of primary care among commercially insured adults in the United States, 2008–2016. Ann Intern Med. 2020;172:240-7. doi:10.7326/M19-1834 LinkGoogle Scholar3. Berchick ER, Hood E, Barnett JC. Health Insurance Coverage in the United States: 2017. Current Population Reports no. P60-264. 2018. Accessed at www.census.gov/content/dam/Census/library/publications/2018/demo/p60-264.pdf on 20 December 2019. Google Scholar4. Vistnes J, Miller GE, Cooper P, et al; Agency for Healthcare Research and Quality. Medical Expenditure Panel Survey Insurance Component 2018 Chartbook. September 2019. AHRQ publication no. 19-0077. Accessed at https://meps.ahrq.gov/mepsweb/data_files/publications/cb23/cb23.shtml on 20 December 2019. Google Scholar5. Brook RH, Keeler EB, Lohr KN, et al. The Health Insurance Experiment: a classic RAND study speaks to the current health care reform debate. Santa Monica, CA: RAND Corporation; 2006. Accessed at www.rand.org/pubs/research_briefs/RB9174.html on 20 December 2019. Google Scholar6. Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83:457-502. [PMID: 16202000] CrossrefMedlineGoogle Scholar7. Andes LJ, Cheng YJ, Rolka DB, et al. Prevalence of prediabetes among adolescents and young adults in the United States, 2005-2016. JAMA Pediatr. 2019:e194498. [PMID: 31790544] doi:10.1001/jamapediatrics.2019.4498 CrossrefMedlineGoogle Scholar8. Case A, Deaton A. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proc Natl Acad Sci U S A. 2015;112:15078-83. [PMID: 26575631] doi:10.1073/pnas.1518393112 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Emory University and Alliant Health Group, Atlanta, Georgia (K.R.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-4000.Corresponding Author: Kimberly Rask, MD, PhD, Alliant Health Group, 1455 Lincoln Parkway, Suite 800, Atlanta, GA 30346; e-mail, Kimberly.[email protected]org.This article was published at Annals.org on 4 February 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDeclining Use of Primary Care Among Commercially Insured Adults in the United States, 2008–2016 Ishani Ganguli , Zhuo Shi , E. John Orav , Aarti Rao , Kristin N. Ray , and Ateev Mehrotra Metrics Cited byDeclining Use of Primary Care Among Commercially Insured Adults in the United StatesDawn E. DeWitt, MDPrimary care visits declining in commercially insured patients in USA 18 February 2020Volume 172, Issue 4Page: 283-284KeywordsGamesHealth careHealth insuranceHealth surveysMotivationPatientsPrevention, policy, and public healthPrimary care physiciansType 2 diabetesYoung adults ePublished: 4 February 2020 Issue Published: 18 February 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...