Acceso que alza al cuidado primario

por Lauren Dubinsky, Senior Reporter | October 01, 2014
The UnitedHealth Center for Health Reform & Modernization and Optum Labs recently conducted an analysis that found that primary care physicians both increase the quality and bring down the cost of care.

The analysis highlighted that in local health care markets that have a higher amount of primary care physicians, there are fewer avoidable hospital admissions and emergency department visits, and also diagnostic imaging is performed less when traditional imaging can be performed.

But it's no secret that there is a shortage of those physicians in the U.S. right now. Primary care visits make up 55 percent of the one billion physician office visits every year in the U.S., according to the Centers for Disease Control and Prevention. Yet the U.S. Department of Health and Human Services reported that about 50 million people in the country live in areas where there is a shortage of primary care physicians.

"Primary care is essential to building a higher-performing health care system that promotes personal well-being and saves consumers and taxpayers money," Dr. Richard Migliori, executive vice president of medical affairs and chief medical officer of UnitedHealth Group, said in a statement. "This research shows the value of improving primary care capacity, not only in terms of improving patients' health but also in catching problems early, and avoiding unnecessary and costly hospital services."

They also found that primary care physicians are mostly in areas with higher median household incomes and where residents are more likely to have insurance coverage. However, there is a higher amount of nurse practitioners and physician assistants in the areas with lower-incomes and fewer insured residents.

The analysis stated that boosting the amount of primary care physicians is not going to solve the problem because the physicians prefer not to be in lower-income and uninsured areas. Additionally, lower reimbursement rates and salaries for primary care physicians make specialties with higher pay look more attractive.

The analysis points to expanding the roles of nurse practitioners and physicians assistants as one potential way to solve the problem. However there is a hurdle in the way — Medicare and Medicaid usually reimburse less for services provided by non-physician primary care providers.

In order to provide the recommended preventative, chronic and acute care, primary care physicians with a panel of 2,000 patients need to work about 17.4 hours a day. If a practice creates multi-disciplinary care teams that would help the practice care for additional patients.

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