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Primary Care Visits Decline 2008-2016

Feb 17, 2020 9:38 am

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.

The author has no conflicts of interest to disclose related to this subject

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