Julie Reiff Researcher Health Care Cost Institute

Health Care Spending Increasing But Not On Primary Care

MedicalResearch.com Interview with:

Julie Reiff Researcher Health Care Cost Institute

Julie Reiff

Julie Reiff BA
Health Care Cost Institute 

MedicalResearch.com: What is the background for this study?

Response: Prior studies have attempted to define primary care spending and quantify such spending. Using definitions from the Milbank Memorial Fund, we used Health Care Cost Institute data to calculate primary care utilization and spending among those age 0-64 with employer-sponsored insurance.

MedicalResearch.com: What are the main findings?

Response: We found that primary care spending, defined as the total spending on services rendered by primary care clinicians (PCCs) and as the total spending on primary care services rendered by PCCs, increased nominally from 2013 to 2017, but decreased as a proportion of total spending.

Utilization, however, increased during this time. This trend was consistent among age groups, with the share of total spending attributed to primary care highest among children and lowest among those age 55-64.

MedicalResearch.com: What should readers take away from your report? 

Response: Readers should take away the fact that two trends are happening simultaneously – the increase in nominal spending on primary care and the increase in total spending from 2013 to 2017. Total spending, however, increased more rapidly, causing the trend of declining primary care spending as a proportion of total spending.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Because of the simultaneous trends we see, future research should evaluate how primary care spending is affecting total spending, if at all. In our paper we suggest that primary care can be both a substitute or a compliment to specialty care. While our findings suggest the latter, it is important that future research explores the relationship between primary care and specialty care.  


Reiff J, Brennan N, Fuglesten Biniek J. Primary Care Spending in the Commercially Insured Population. JAMA. 2019;322(22):2244–2245. doi:https://doi.org/10.1001/jama.2019.16058


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Last Updated on December 11, 2019 by Marie Benz MD FAAD