Coincidence? CT spends little on primary care, and we have high ED, preventable hospitalization rates

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A new analysis finds that Connecticut, at only 3.5% of our health care dollars spent on primary care, is last among 29 states studied. Not surprisingly, we also rank among the highest in ED visits, all hospitalizations, and in avoidable hospitalizations. The US average is 5.6% of health care spending devoted to primary care, well behind the OECD nations’ average of 14%. The analysis by the Patient Centered Primary Care Collaborative used 2011 through 2013 MEPS survey data. Primary care emphasizes the whole person and disease prevention and management. Primary care includes family medicine, general practice, geriatrics, general internal medicine and general pediatrics. There is a large and growing literature linking better health outcomes, fewer inequities, and lower costs with primary care spending and Patient-Centered Medical Homes. (It should be noted that using a broader definition of primary care spending that includes OB/Gyn, PAs, NPs, and behavioral health services, CT is slightly above the national average.)

Among Connecticut payers, Medicaid/CHIP spends the most (5.4%) on primary care, followed by 4.5% for the uninsured, 3.6% for private payers, 2.5% for Medicare/Medicaid dual eligibles, and only 2.1% for Medicare. All these rates are below the US average. Interestingly, the authors found little correlation of primary care spending rates between payers within states. As for the nation, Connecticut primary care spending is highest for the youngest residents (0 to 5 years at 28.6%) and tapers down as we age (65 to 74 years at 2.6%). Women spend slightly more than men on primary care, both in Connecticut and across the US. The CT Health Policy Project recently collected ideas to support primary care in Connecticut.