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A national claims-based analysis has shown a consistent decline, by commercially insured adults (18-64 yrs), in primary care physician visits from 2008 to 2016; with nearly one half having no PCP visits in a given year by 2016.
Efforts to contain costs and improve clinical outcomes often center around coordinated medical care through PCPs.
Researchers used a 5% claims sample from 142 million primary care visits (94 million member-years) to examine PCP engagements.
From 2008 to 2016, PCP visits declined by 24.2%, from 169.5 to 134.3 visits per 100 member-years. At the same time the number of adults with no PCP visits in a given year rose from 38.1% to 46.4%.
Rates of visits addressing low-acuity conditions decreased by 47.7% and the decline was largest among the youngest adults (−27.6%), those without chronic conditions (−26.4%) and those living in the lowest-income areas (−31.4%).
The out-of-pocket cost per problem-based visit rose by $9.4 (31.5%).
Visit rates to specialists remained stable (−0.08% [CI, −0.56% to 0.40%]), and visits to alternative venues, such as urgent care clinics, increased by 46.9% (CI, 45.8% to 48.1%).
These results suggest that this decline may be explained by decreased real or perceived visit needs, financial deterrents, and use of alternative sources of care.