New report finds that 29% of patients receiving medical care from 2016 to 2022 did not visit a primary care provider 

March 17, 2023 – Nationally, from 2016 to 2022, 29 percent of patients receiving medical care did not visit a primary care provider, according to a new white paper from FAIR Health. This ranged from a high of 43 percent in Tennessee to a low of 16 percent in Massachusetts. These and other findings are detailed in the new report, released today, entitled A Window into Primary Care: An Analysis of Private Healthcare Claims. 

Drawing on the nation’s largest private healthcare claims database, US census data and National Plan and Provider Enumeration System (NPPES) data, this report provides an in-depth analysis of primary care with a focus on geography, physician versus nonphysician care and primary care specialties. In addition, the study reports on allowed amounts, telehealth utilization, diagnoses and behavioral health. 

Some key findings: 

  • Of the providers who performed primary care services in 2016-2022, 56% were physicians, while 44% were nonphysicians. 
  • Nurse practitioners constituted the largest share of primary care providers by specialty (27%), followed by family medicine physicians (20%), internal medicine physicians (18%) and physician assistants (15%). Smaller percentages were accounted for by pediatricians, obstetricians/gynecologists and others. 
  • The five states with the highest percentage of primary care patients receiving care from a nurse practitioner in 2016-2022 were largely states that permitted full scope of practice. Conversely, the states with the lowest percentage were generally those that reduced or restricted practice. 
  • The five states with the highest percentage of primary care patients receiving care from a family medicine physician in 2016-2022 were more likely to be rural. 
  • Telehealth use sharply increased at the start of the COVID-19 pandemic in all primary care specialties studied. Telehealth use then declined by over 30 percent in all primary care specialties studied from 2020 to 2021. 
  • In the period 2016-2022, nonphysicians treated greater percentages of patients with diagnoses related to mental health or acute respiratory diseases and infections than physicians did. 

FAIR Health President Robin Gelburd stated: “Primary care is vital to the nation’s healthcare system. We hope this study of primary care provides actionable findings for all healthcare stakeholders, including patients, providers, payors, policy makers and researchers.” 

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