Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

3 ways to improve primary care access

Richard Migliori, MD and Grace Terrell, MD
Policy
October 4, 2014
Share
Tweet
Share

Primary care is essential to building a higher-performing health care system that promotes personal well-being and saves consumers and taxpayers money. Research shows that more primary care physicians in a community means lower rates of mortality, better preventive care, and fewer hospitalizations and emergency room visits.

Unfortunately, too many Americans lack easy access to primary care.  Approximately 50 million Americans live in areas, mostly rural, with too few primary care physicians. And a new report released by the UnitedHealth Center for Health Reform & Modernization shows that socioeconomic factors help explain this geographic variation in supply. Even in more urban areas, primary care physicians tend to practice in higher-income areas where individuals are more likely to have insurance coverage.

If current trends continue, the shortage of primary care providers is likely to get worse.  Only about one in three physicians practice primary care. As demand for primary care increases due to expanded insurance coverage and an aging and sicker population, only one in six medical graduates is choosing primary care. The good news is there are steps we can take right now to expand primary care capacity and improve access.

The following actions are proven, scalable ways to increase access to primary care:

Expand the roles of nurse practitioners and physician assistants. Primary care practices led by physicians can expand capacity by better leveraging a diverse clinician workforce — including 200,000 nurse practitioners and 100,000 physician assistants nationwide. Most are concentrated in underserved areas already.  While laws governing scope of practice vary by state, there are opportunities to better utilize these skilled providers to boost capacity and improve access to primary care.

Assemble multi-disciplinary care teams to deliver care more efficiently.  It would take 17 hours for a primary care physician to provide all recommended care to a panel of 2,000 patients — and many have larger panels.  In addition to nurse practitioners and physician assistants, care teams should expand the role of medical assistants, who manage patients’ health records and walk patients through their care plans, as well as health coaches, who work with patients on behavioral change.  In smart payment models that prioritize value, team-based approaches not only deliver primary care more effectively — they also can be self-sustaining.  The increased revenue from additional patient visits supports the costs of additional team members. Moving to team-based care makes sense both clinically and financially for physician practices.

Use electronic health records and other health information technology (HIT) to share information across the delivery system in real time.  The broad use of technology, especially in a team-based practice can increase capacity and expand access to primary care.  Though HIT alone will not achieve dramatic improvements in primary care delivery, it is an essential building block, enabling practices to use resources as efficiently and effectively as possible. Electronic patient health records that travel through a single, user-friendly, interoperable system designed to share information system-wide are critical to achieving this goal. Federal resources are available to help physicians acquire HIT, but we need to ensure that physicians who invest in HIT to improve care are rewarded financially.

All three of the above actions — using non-physician providers, assembling clinicians in teams and supporting team-based care with HIT to increase primary care capacity and improve access — can be tailored to local market conditions and policy environments. Primary care is too important to the future of health care to leave on the table these practical options to increase capacity and improve access to primary care services.

Let’s give medical school graduates a reason to practice primary care, support them in driving higher health system performance and enable them to practice in communities where their services are needed most.

Richard Migliori is executive vice president and chief medical officer, UnitedHealth Group. Grace Terrell is president and CEO, Cornerstone Health Care.

Prev

Apply the lessons learned from the ice bucket challenge

October 4, 2014 Kevin 3
…
Next

Marijuana and motor vehicle safety: An impending public health dilemma

October 4, 2014 Kevin 8
…

Tagged as: Primary Care

Post navigation

< Previous Post
Apply the lessons learned from the ice bucket challenge
Next Post >
Marijuana and motor vehicle safety: An impending public health dilemma

ADVERTISEMENT

More in Policy

  • Unused IV catheters cost U.S. hospitals billions

    Piyush Pillarisetti
  • Why your health care dashboard isn’t working and how to fix it

    Dave Cummings, RN
  • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

    Robert E. White, Jr. & The Doctors Company
  • How new loan caps could destroy diversity in medical education

    Caleb Andrus-Gazyeva
  • Why transplant equity requires more than access

    Zamra Amjid, DHSc, MHA
  • Ideology, not evidence, fuels the anti-trans agenda

    Andie Riffer, PhD and Shawn E. Parra, LCSW, MSW
  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why I left the clinic to lead health care from the inside

      Vandana Maurya, MHA | Conditions
    • How doctors can think like CEOs [PODCAST]

      The Podcast by KevinMD | Podcast
    • A surgeon’s testimony, probation, and resignation from a professional society

      Stephen M. Cohen, MD, MBA | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]

      The Podcast by KevinMD | Podcast
    • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

      Yousuf Zafar, MD | Physician
    • Psychiatrist tests ketogenic diet for mental health benefits

      Zane Kaleem, MD | Conditions
    • The hidden rewards of a primary care career

      Jerina Gani, MD, MPH | Physician
    • Why physicians should not be their own financial planner

      Michelle Neiswender, CFP | Finance
    • Why doctors regret specialty choices in their 30s

      Jeremiah J. Whittington, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 58 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why I left the clinic to lead health care from the inside

      Vandana Maurya, MHA | Conditions
    • How doctors can think like CEOs [PODCAST]

      The Podcast by KevinMD | Podcast
    • A surgeon’s testimony, probation, and resignation from a professional society

      Stephen M. Cohen, MD, MBA | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]

      The Podcast by KevinMD | Podcast
    • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

      Yousuf Zafar, MD | Physician
    • Psychiatrist tests ketogenic diet for mental health benefits

      Zane Kaleem, MD | Conditions
    • The hidden rewards of a primary care career

      Jerina Gani, MD, MPH | Physician
    • Why physicians should not be their own financial planner

      Michelle Neiswender, CFP | Finance
    • Why doctors regret specialty choices in their 30s

      Jeremiah J. Whittington, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

3 ways to improve primary care access
58 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...