V. Research: There are few federal funding opportunities for primary care research.

To implement high-quality primary care, it is important to identify the components of high quality care, study how best to implement the components, and measure its impact on outcomes. To this end, the NASEM report said research on primary care systems, delivery models, and quality of primary care must be supported. Traditionally, funding dedicated to primary care research has been limited, and investments in federal agencies that are tasked with researching primary care have been tenuous and inadequate.^{30, 31}

From 2017 to 2021, the percentage of National Institutes of Health (NIH) research funding allocated to family medicine has remained flat at just above 0.2% (Figure 8). Although family medicine is not the only primary care specialty, we chose it for this measure because it is the specialty with the highest number of health care encounters in the United States.³² Moreover, tracking research funding related to primary care for internal medicine and pediatrics is difficult because some of that research covers subspecialties and/or focuses on inpatient settings. It’s also important to acknowledge that agencies other than the NIH support primary care research. Still, an in-depth analysis conducted by RAND using a more complex methodology to define primary care research and looking at more federal agencies found similar results^.33

Figure 8. NIH Investment in Primary Care in Millions of Dollars and as a Percentage of Total Funding

Tracking the research dollars that are invested in studying primary care will allow for accountability and should result in a shift of federal research dollars toward studying the only specialty that has been shown to decrease morbidity and mortality and improve the health of the population.³⁴

Notes

30. Lucan SC, Phillips RL, Bazemore AW. Off the roadmap? Family medicine’s grant funding and committee representation at NIH. Ann Fam Med. 2008;6(6):534-542. doi:10.1370/afm.911
31.Mainous A, Porter M, Agana D, Chessman A. Institutional NIH research funding and a culture of support for family medicine—their relationship to family medicine specialty choice. Fam Med. 2018;50(5):369-371. doi:10.22454/FamMed.2018.913629
32. Willis J, Antono B, Bazemore A, et al. The State of Primary Care in the United States: A Chartbook of Facts and Statistics. Robert Graham Center; 2021.https://www.graham-center.org/content/dam/rgc/documents/publications-reports/reports/PrimaryCareChartbook2021.pdf
33.Mendel P, Gidengil C, Tomoaia-Cotisel A, et al. Health Services and Primary Care Research Study: Comprehensive Report. RAND Corporation; 2020. doi:10.7249/RR3229
34. Basu S, Berkowitz SA, Phillips RL, Bitton A, Landon BE, Phillips RS. Association of primary care physician supply with population mortality in the United States, 2005-2015. JAMA Intern Med. 2019;179(4):506-514. doi:10.1001/jamainternmed.2018.7624