The Fund supports networks of state health policy decision makers to help identify, inspire, and inform policy leaders.
A bipartisan group of state health policymakers from both the executive and legislative branches who are focused on improving population health.
Networks of state officials, advocates, and others aiming to invest in and transform primary care.
A program dedicated to advancing state-based efforts to make health care more affordable for residents, employers, and states.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
A leadership development program for early and mid-career state government officials who are committed to improving the health of all people in their communities.
A leadership program for senior state government officials who are committed to improving population health.
The Fund focuses on creating an affordable health care system built on strong primary care and partnerships that improve health outcomes for all.
Improving state leaders’ ability to enact and implement evidence-based health policies.
Advancing policies that create a more prevention- and primary care-oriented health system.
Improving population health through policies that contain health care cost growth.
Our state health policy resources offer relevant data analysis and best practices.
The Fund publishes reports, issues briefs, and case studies on state health policy issues.
Short takes on health policy issues from Milbank staff and guest authors.
Insights from Milbank President Debra Lubar on state health policymaking.
Reported articles and Q&As on timely health policy issues, as well as foundation updates.
Milbank Memorial Fund and Milbank Quarterly webinars featuring state health policymakers and researchers.
Updates and expert contact information for reporters.
The Milbank Memorial Fund is a private foundation that works to improve population health and health equity.
September 13, 2023
Policy Report
Jane L. Tavares
Marc A. Cohen
Publication
Jul 13, 2026
Apr 14, 2026
Feb 12, 2026
Having a usual source of care (USC) — a health professional or care location where one can go if sick or in need of medical advice — is a key component of achieving better health outcomes and having a more positive experience with the health care system. Using data from the nationally representative Health and Retirement Study (HRS), this study examines recent trends (2014-2020) in the use of a USC among those age 50 and older, with a focus on racial/ethnic disparities and other socio-demographic characteristics, including type of health insurance coverage. The analysis found that people with a USC tend to be wealthier, White, and generally healthier than those without a USC. Between 2014 and 2020 there has been a decline in the use of a USC across all groups except for those enrolled in managed care. Results showed that people tend to either gain or lose a USC with major life changes, and that being a person of color was associated with higher odds of losing a USC as were decreases in income. Finally, although individuals with a USC used more health care services overall, there was no evidence that they utilized high-cost hospital services more than those without a USC.
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