Drop in visits to primary care providers seen for insured adults

From 2008 to 2016, there was a decrease in commercially insured adults' visits to primary care providers (PCPs), according to a study published online Feb. 4 in the Annals of Internal Medicine.

Ishani Ganguli, M.D., M.P.H., from Harvard Medical School in Boston, and colleagues examined PCP visit trends among adults enrolled with a commercial insurer and assessed factors underlying these trends. Data were included from the insurer for 2008 to 2016 for 142 million primary care visits among 94 million member-years.

The researchers observed a 24.2 percent decrease in visits to PCPs, from 169.5 to 134.3 visits per 100 member-years, while there was an increase in the proportion of adults with no PCP visits in a given year, from 38.1 to 46.4 percent. A 47.7 percent decrease was seen in the rates of visits addressing low-acuity conditions. The largest decreases were seen among the youngest adults, those without chronic conditions, and those living in the lowest-income areas (−27.6, −26.4, and −31.4 percent, respectively). Per problem-based visit, there was a $9.4 increase in out-of-pocket cost (31.5 percent). Visit rates to specialists remained stable (−0.08 percent), while there was an increase in visits to alternative venues such as urgent care clinics (46.9 percent increase).

"Our results show a substantial decline in primary care visit rates that seems to be associated with decreased (real or perceived) need for some primary care visits, rising financial barriers, and increased use of alternative venues of care," the authors write.

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