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A recent report commissioned by the New England States Consortium Systems Organization (NESCSO) found that spending on primary care in six New England states varies widely from 4.9% to 8%, representing an average of 5.5% of overall health care spending. The figures were based on administrative claims data for 7.2 million commercial, Medicare, and Medicaid members in Connecticut, Rhode Island, Massachusetts, New Hampshire, Vermont, and Maine.
Conducted by Onpoint Health Data with support from the Milbank Memorial Fund, The New England States’ All-Payer Report on Primary Care Payments was pursued to standardize how primary care spending across states and payer categories is measured. These measures provide a gauge for investment in primary care, which has been shown to improve health care quality and costs and reduce disparities.
“The development of a standardized way to measure investment could serve as the basis for a regional benchmark, as well as public policies that aim to reorient health systems toward primary care,” says Milbank Memorial Fund program officer Rachel Block.
The analysis was based primarily on data from the states’ all-payer claims databases. While some non-claims data, such as value-based payment like capitated or per-patient payment, was collected directly from payers, the report authors point to the need for policymakers to consider requirements for payers to report on non-claims data, particularly as value-based models of care become more common.
The authors also identified future areas of focus for health care researchers, such as developing a standardized approach to evaluating the association between primary care payments and performance outcomes, as well as the impact of COVID-19 on primary care payments, total health care expenditures, and other outcome measures.
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