Massachusetts Provider Organizations with Higher Primary Care Investment Offer Better Value, New Research Finds

There is a considerable body of research demonstrating the long-term benefits of primary care. However, for decades, the United States has underinvested in primary care, spending only 5 to 7 cents of every health care dollar on it versus 13 cents in other high-income countries.[i] To help address these concerns, more than a third of states have passed legislation or enacted regulations aimed at increasing the percentage of healthcare spending that goes toward primary care.[ii]

A common challenge is relatively scarce research demonstrating that increased spending on primary care directly improves outcomes or lowers costs.

A recent report by Freedman HealthCare with support from the Commonwealth Fund, uses data on commercial primary care spending, total medical expense, and care quality from the Massachusetts Center for Health Information and Analysis (CHIA) to analyze whether provider organizations with higher primary care investment perform better on measures of quality and spending. It also models how these findings could inform legislative and regulatory efforts to increase primary care investment using legislation in Massachusetts as an example. Highlights of the findings are provided below. To read the full report, click here.

Highlights:

• Provider organizations with higher primary care investment as a percentage of total spending performed significantly better on standardized measures of quality and had significantly lower spending on inpatient and outpatient hospital services.
• Provider organizations with higher primary care investment as a percentage of total spending did not have significantly higher total spending. This suggests that primary care does not lead to an increase in overall health care spending, while also improving quality of care.
• If all Massachusetts provider organizations performed as well as the top performer, nearly $600 million per year would have been saved on inpatient and outpatient hospital services. If all provider organizations performed at the state average, more than $200 million per year could be saved.
• Assuming robust provider participation and a commitment to reallocate new dollars to implementing the primary care transformers, modeling found the Massachusetts program could cover its own costs by Year 4 and potentially generate additional savings in future years.

Sources:

[i] World Health Organization. “Health expenditure on primary healthcare.” WHO, https://www.who.int/news-room/fact-sheets/detail/health-expenditure-on-primary-health-care. Accessed May 31, 2024.

[ii] Primary Care Collaborative. (n.d.). State Primary Care Investment Initiatives. Retrieved from https://thepcc.org/primary-care-investment/legislation