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    States move to prioritize primary care


    achieve its goals, Covered California this year began requiring all enrollees to be matched with a primary care physician, nurse practitioner or another primary care clinician as a patient advocate and first point of contact. 

    Enhanced primary care is also having an impact in Rhode Island where Medicaid accounts for about one-third of the state’s budget. The state saw a significant drop in total medical spending after its health insurance commissioner required all commercial plans to increase spending on primary care by 1% of total spending per year over a five-year period. Between 2008 and 2012, Rhode Island’s three largest commercial insurers increased spending on primary care by 37% while total medical spending fell 14%.


    POPULAR BLOG: My proposal to change the American healthcare system for the better


    Also in Rhode Island, a pilot primary care project sent nurse practitioners and graduate students to the homes of financially disadvantaged patients with chronic health issues, resulting in decreases of more than 60% in both hospitalization rates and emergency department visits over a six-month period in 2016.

    Despite the proven potential of primary care to deliver higher-quality and lower-cost care, a number of obstacles stand in the way of delivering on that promise. Current spending on primary care represents just 6% of total health care spending, half the 12% minimum amount the American Academy of Family Physicians says is needed. 

    There’s also a shortage of primary care specialists, a situation that’s projected to worsen over the next several years even as the demand for primary care services increases. 

    It’s not hyperbole to assert that these are life-and-death issues. Increasing the number of physicians specializing in primary care could save the lives of more than 100,000 Americans deaths a year.

    For that, and many other reasons, the primary care initiatives in Oregon and the other states represent important leadership that others can follow. We need to do a lot more to support and promote primary care to ensure it realizes its full potential as the underpinning of the nation’s health care system.


    Glen R. Stream is a family physician in La Quinta, California, and president of Family Medicine for America’s Health, which sponsors the Health is Primary campaign.

    Glen Stream, MD, FAAFP, MBI
    Dr. Glen Stream, a family physician practicing in La Quinta, California, is past president of the American Academy of Family Physicians. ...


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    • Anonymous
      Way too late! Family practice has been crapped upon by insurers, hospitals and specialists. I just talked to a medical student who is going through her family medicine rotation. She thought it might be the right area for her. After just a few weeks she has realized she can pick a specialty that will pay better and allow her to have a better lifestyle. We let everybody crap on our plate and tell us it was dessert for the past 20 years. Now let the NP's and PA's put up with the scut work.
    • Anonymous
      1. This is good news for all of the mid-level providers that compete with primary care physicians. 2. It never ends well when insurance companies or government agencies pick winners and losers.

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