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February 27, 2024
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Yalda Jabbarpour
Anuradha Jetty
Hoon Byun
Anam Siddiqi
Stephen Petterson
Jeongyoung Park
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One of the major NASEM committee recommendations centered on tracking the nation’s progress toward strengthening primary care. An initial step toward establishing accountability is conducting research to understand what is happening in primary care and what is needed: who is delivering primary care, how they are delivering primary care, what impact it’s having on health, and where gaps exist, including disparities in access and outcomes. Yet, over the past decade, federal agencies responsible for research (including the National Institutes of Health, the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, and the Food and Drug Administration) have devoted only 0.3% of their yearly budget to studying primary care (Figure 12).
Over the past decade, federal agencies responsible for research (including the NationalInstitutes of Health, the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, and the Food and Drug Administration) have devoted only 0.3% of their yearly budget to studying primary care.
Data Source: NIH RePORTER, 2017–2022.Notes: Federal investment includes spending from the National Institutes of Health (NIH), the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, and the Food and Drug Administration. Funding given to family medicine departments was used as a proxy for funding to primary care.
Not only is funding well under 1%, but the data sources available to track primary care are incomplete, complicated to use, expensive, and inconsistent in what data are reported year after year. Two clear examples are the data gaps around health technology in primary care and our inability to monitor progress toward hybrid payment that combines fee-for-service payment with per-patient payment (as called for in the NASEM report). Another is the dearth of timely information around current practice location and specialty of NPs and PAs, as well as information about where they trained. (The limitations of all the data sets explored for the 2023 and 2024 Scorecard are listed in the Appendix.)
Methods Note: Data Limitations
As noted in the report, the data sources available to track primary care are incomplete. We outline here the data needs that we have identified while preparing the Scorecard.
Workforce and Access Data
Training Data
Payment Data
Health Information Technology (HIT) Data
Notes