A key solution to health care costs and quality is staring us in the face

Sept. 15, 2021 / By L. Gordon Moore, MD

Click to listen to the podcastHow can we reduce health care cost trends while improving access and quality? The answer is staring us in the face.

Maybe we need a new app that tracks every waking and sleeping moment of every American so that companies can better target their ads companies can remind us to take our meds, or maybe we should give artificial intelligence (AI) apps all our medical information so that companies can better target their ads we can tailor medical recommendations?

While private equity continues to throw billions of dollars into these ideas, to make a bigger impact, we could shift more health care dollars to primary care. High functioning primary care is the foundation of high performing health care systems: People have easy access to a clinician who knows them as a person, provides comprehensive services and coordinates any health care services that person needs.

Populations who have access to high performing primary care experience longer life expectancy as well as lower rates of unnecessary emergency room visits and hospital care. Populations served by high performing primary care achieve these outcomes with lower per capita health care costs.[1] Countries doing well on these measures spend 15-20 percent of their health care dollars on primary care.[2]

Unfortunately for us as Americans, we’re heading in the opposite direction: We spend 5-7 percent of every health care dollar on primary care – and that share is declining.[3] The remaining majority is spend on specialty care and hospitals and administrative costs, but the key point is that the percent spending on primary care is inadequate to the work.  High performing primary care reduces unnecessary spending downstream.  With a high performing primary care foundation, populations spend less on health care per capita and have better population outcomes. Primary care in the U.S. does not have funding for the basic infrastructure required of high performing primary care. We pay doctors for each office visit, resulting in transactional rapid turnstile care rather than funding the team of nurses, health coaches and others working collaboratively to help people and populations.

The Primary Care Collaborative (PCC) is a not-for-profit, multi-stakeholder organization that started in part when some U.S. business leaders noticed that their employees in other countries were getting better care and better outcomes for less cost than in the U.S. Since its inception in 2006, the PCC has been promoting policies and sharing best practices that support growth of high performing primary care.

Listen to the PCC’s President and CEO Ann Greiner describe the current state of health care in the U.S. and the solutions that are staring us in the face on the 3M Inside Angle podcast.

Dr. Gordon Moore is senior medical director, Clinical Strategy and Value-based Care for 3M Health Information Systems.

[1] Macinko, James, Barbara Starfield, and Leiyu Shi. “Quantifying the Health Benefits of Primary Care Physician Supply in the United States.” International Journal of Health Services: Planning, Administration, Evaluation 37, no. 1 (2007): 111–26.

[2] https://www.milbank.org/focus-areas/primary-care-transformation/ Accessed 9/9/2021

[3] https://www.milbank.org/focus-areas/primary-care-transformation/other-resources/ Accessed 9/9/2021