Access to primary care is a significant challenge for many people living in the U.S. Individuals who are insured, as well as those who are uninsured, struggle with this issue. It affects rural, urban and suburban communities. In fact, 13 percent of U.S. residents (44 million) live in a county with a primary care physician shortage, defined as less than one primary care physician per 2,000 people.2
In the coming years, demand for primary care will increase significantly as the U.S. health care system serves a larger, older, and less healthy population. And the supply of primary care physicians will continue to be insufficient to meet the demand. It's estimated that the shortage of primary care physicians could grow from 18,000 in 2018 to 49,000 in 2030.14
A new report from UnitedHealth Group, Addressing the Nation's Primary Care Shortage: Advanced Practice Clinicians and Innovative Care Delivery Models outlines opportunities to increase primary care capacity.
Advanced Practice Clinicians
Nurse practitioners (NPs), physician assistants (PAs), and certified nurse midwives (CNMs) represent a growing part of the nation's primary care workforce. These advanced practice clinicians practice independently or as part of multidisciplinary care teams that help primary care practices care for more patients.
A meaningful, timely opportunity to increase primary care capacity is to allow NPs to practice to the full extent of their education and training. NPs are qualified to independently deliver high-quality primary care and already do so in 22 states. Under a broader definition of primary care provider that includes NPs, if all states were to allow NPs to practice to the full extent of their graduate education, advanced clinical training, and national certification:
- The number of U.S. residents living in a county with a primary care shortage would decline from 44 million to fewer than 13 million – a 70 percent reduction.
- The number of rural residents living in a county with a primary care shortage would decline from 23 million to 8 million – a 65 percent reduction.
Innovative Care Delivery Models
Innovative care delivery models – including urgent care centers, retail health clinics, and in-home clinical visits – also enhance efforts to increase primary care capacity and access to care.
Urgent care centers and retail health clinics meet consumers' needs for reliable triage and cost-effective treatment delivered in convenient walk-in locations with extended hours and low wait times. In-home clinical visits are another effective approach to delivering primary care and preventive services.
- In a program for Medicare beneficiaries, individuals receiving in-home clinical visits were associated with a decline in hospitalizations and nursing home admissions, an increase in physician office visits, and higher diabetes and COPD detection rates.34