Primary care spending, as a percentage of overall spending, varied widely among the eight health plan products examined in the report, from a low of 4.9% to a high of 11.4%.
Investing in primary care is associated with better quality medical care, fewer hospital visits, and savings of $2.4 billion annually in California, according to a new study.
The report -- Investing in Primary Care: Why It Matters for Californians with Commercial Coverage -- looked at eight health plans covering 80% of commercially insured adults in California, almost 14 million people. The report finds that primary care spending, as a percentage of overall spending, varied widely among the health plan products, from a low of 4.9% to a high of 11.4%.
The researchers speculated that if lower-spending providers matched the highest-spending providers, California could see 25,000 fewer acute hospital stays, 89,000 fewer emergency room visits, and a $2.4 billion reduction in overall healthcare spending in one year. As an added bonus, providers would see higher patient satisfaction and quality improvement scores.
"This study is the first analysis of health plan-level primary care investment in California and also the first to delve into primary care spending at the provider organization level, allowing for more granular analysis on the impact of primary care on quality and cost,” said study coauthor Dolores Yanagihara, MPH, with Integrated Healthcare Association. "Our analysis adds to the growing body of evidence that investing in primary care produces higher value and better outcomes for patients and purchasers."
The report comes as a new California Health Care Foundation / NORC Health Policy Survey reveals big differences between insured Californians who have a primary care provider and those who don't. Insured Latinos were the least likely to have a primary care provider compared to other insured Californians.
Californians who have a primary care provider have fewer language, distance, and affordability barriers to care and are less likely to delay care and are less likely to report negative provider experiences.
Kathryn E. Phillips, senior program officer at CHCF, said despite decades of research showing the cost-effectiveness of investing in primary care, "America, on average, spends only about five cents of every health care dollar on primary care."
The Primary Care Investment Coordinating Group of California, led by CHCF, Covered California, CalPERS, and other state agencies and business associations, are joining more than a dozen other states that are pushing for an increased share of healthcare dollars devoted to primary care.
"The shared, sweeping commitment of PICG members signals a major shift in priorities for healthcare in California and is intended to spur new investment in primary care throughout the state and the nation," Phillips said.
“This study is the first analysis of health plan-level primary care investment in California and also the first to delve into primary care spending at the provider organization level, allowing for more granular analysis on the impact of primary care on quality and cost. Our analysis adds to the growing body of evidence that investing in primary care produces higher value and better outcomes for patients and purchasers.”
Dolores Yanagihara, MPH, with Integrated Healthcare Association.
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.
KEY TAKEAWAYS
The researchers speculated that if lower-spending providers matched the highest-spending providers, California could see 25,000 fewer acute hospital stays, 89,000 fewer emergency room visits, and a $2.4 billion reduction in overall healthcare spending in one year.
The report comes as a new California Health Care Foundation / NORC Health Policy Survey reveals big differences between insured Californians who have a primary care provider and those who don't. Insured Latinos were the least likely to have a primary care provider compared to other insured Californians.