AAFP attempts to map the impact of primary care spending on care outcomes

The importance of the primary care physician in impacting the quality of care a patient receives has become increasingly evident. The primary care physician has the ability to coordinate care between specialty providers and healthcare facilities, to ensure the patient receives consistent, appropriate care for a particular condition and on an ongoing basis. Two states, in particular, have realized that spending on primary care can affect those care outcomes.

The American Academy of Family Physicians (AAFP) recently hosted a webinar to help their members understand the impact of primary care spending so they can “bring the same success to their states.” As part of the program, Evan Saulino, M.D., Ph.D., a family physician at Providence Medical Group-Southeast in Portland, Oregon, discussed his state’s emphasis on primary care spending.

Oregon was one of the first states to study primary care spending and then act on their results. In February 2017, a report was presented to the Oregon legislature that “revealed that about 12.5 percent of the total medical spending of Medicaid coordinated care organizations went to primary care, while other payers spent only about 9.5 percent on primary care.” The state followed up four months later with a law “requiring more insurers to devote 12 percent of total spending on physical and mental health to primary care.”

Even before Oregon’s initiative, though, Rhode Island was beginning the process of researching and emphasizing the need for primary care spending. A study conducted in 2008 “compared the primary care budgets of insurers in the state to those of high-performing health systems in other states. The figure was 5.9 percent in Rhode Island, far behind the high of 14 percent in a Washington state-based system.”

After a law was passed requiring insurers to spend more on primary care, a follow-up study was conducted. In 2014, the research from that study “found that as this spending increased by 37 percent between 2008 and 2012, total medical spending declined by 14 percent.”