The Importance Of Primary Care—And Of Measuring It

When it comes to US health care, the adage of “you get what you pay for” does not apply. The US spends more on health care than any other country, but we have lower-quality care and worse outcomes than many nations that spend considerably less.

This disconnect stems from how we spend our money. Research confirms that advanced primary care, such as patient-centered medical homes and other accountable care models, help fulfill the “quadruple aim”: high-quality care, better health, lower costs, and improved experience for clinicians and staff in the delivery of care.

Despite this understanding, the best available estimates indicate that the percentage of health care spending devoted to primary care in the US is an anemic 5 percent to 7 percent. In a recent study, RAND Corporation researchers estimated that just 2.12 percent to 4.88 percent of total Medicare fee-for-service medical and prescription drug spending goes toward primary care. High-performing health care systems in other countries spend double or triple that amount.

One way to bridge this gap, which Anthem and the Patient-Centered Primary Care Collaborative (PCPCC) both support, is to promote new approaches to delivering primary care, such as value-based payment models. The Center for Medicare and Medicaid Innovation’s April 22 announcement about five new voluntary primary care payment models is a significant step toward paying for value rather than volume.