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This Week in Primary Care
The Cost vs. Payment Issue
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In Primary Care for All Americans local and state workgroups, we focus on improving primary care workforce, workload, and payment, so that everyone has a high-functioning team to do their primary care. A new report out of the Office of the Health Insurance Commissioner of Rhode Island gets at all three.
The Office independently modeled the actual operating expenses of delivering primary care under different team configurations, then compared expenses to the payments practices were receiving.
And found that prevailing payment rates do not cover the costs of delivering primary care.
In fact, the Office recommends 48% to 66% payment increases to adequately cover just the cost of delivering traditional primary care (a clinician working with a medical assistant). To give the best chance of connecting everyone in Rhode Island to high-quality primary care, they recommend setting aside additional money to build expanded care teams, which would include amongst other professionals nurses, clinical pharmacists, and social workers.
These payments are not unique to Rhode Island– the report finds that Medicaid and Medicare payments for primary care are in fact commensurate with the rest of New England. The shortfall is driving a shrinking workforce and growing workload for primary care teams, with the result that about 30% of adults and 14% of children lack a usual source of care.
How do we rebalance cost with payment? Tonight we will host a Teach-In/Learn-In with Dr. Wayne Altman, a key organizer behind two bills that would double primary care spending in Massachusetts. Please bring your experiences, questions, and ideas and join us tonight!
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