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The Fund identifies and shares policy ideas and analysis on topics important to state health policymakers, particularly on issues related to state leadership, primary care, aging, and health care costs.
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The Fund publishes The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to health policy leaders.
The Milbank Memorial Fund is an endowed operating foundation that publishes The Milbank Quarterly, commissions projects, and convenes state health policy decision makers on issues they identify as important to population health.
July 19, 2019
Primary Care Transformation Primary Care Investment
Alyssa Neumann Kane
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Read more about the process for developing standard measure for primary care investment in a August 6, 2019 Health Affairs blog by Hoangmai Pham, MD, MPH, vice president of provider alignment solutions for Anthem, and Ann Greiner, president and CEO of PCPCC and in a July 27, 2019 Lancet editorial.
Relative to its international counterparts, the United States underinvests in primary care, as reflected in spending by both public and private payers. On average, the United States spends 5%–7% on primary care as a percentage of total health care spending. By comparison, Organisation for Economic Co-operation and Development (OECD) countries average 14% spending on primary care.
This underinvestment represents a major disconnect given the robust evidence base showing that health systems with a primary care orientation have superior patient outcomes, fewer inequities, and lower costs. On these key attributes, performance of the U.S. health system pales in comparison to systems in other industrialized nations.
In a first-of-its-kind study, the 2019 Patient-Centered Primary Care Collaborative (PCPCC) Evidence Report examines states’ primary care spending patterns, including spending across payer types, and considers the implications of these results for select patient outcomes.
More specifically, the 2019 PCPCC Evidence Report finds:
State leaders have a growing interest in using their legislative and regulatory authority to measure and report on primary care spend and, in some cases, to set targets for increasing investment in primary care over the coming years within their jurisdictions. This report provides a high-level description of such efforts in 10 states, seven of which initiated their efforts in 2019. This focus on primary care spend and primary care investment suggests policymakers have some momentum to shift the U.S. delivery system back to its primary care foundation, so that it can better address diverse patient needs across different age and sociodemographic groups.
Read the report.
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An endowed operating foundation that engages in nonpartisan analysis, collaboration, and communication, with an emphasis on state health policy.