Primary care is undervalued and underfunded, despite evidence that it improves health outcomes and reduces costs.
The Primary Care Development Corporation (PCDC) applauds the introduction of A.7230/S.6534. Introduced by Senator Gustavo Rivera, Chair of the Senate Health Committee [pictured right], and Assembly Member Richard Gottfried, Chair of the Assembly Health Committee [pictured left], the legislation would strengthen primary care through increased access to and affordability of care across the state. Lack of investment in primary care and prevention has led to rising health care costs and increasing rates of chronic illness, leaving New Yorkers vulnerable to threats like COVID-19. Investment in primary care is a crucial step in rebalancing the priorities of New York State’s health system and rebuilding our communities after COVID-19.
To date, at least ten states have acted to rebalance their health care spending through legislative, regulatory, or executive means. PCDC believes New York State must be next to act and is launching a statewide campaign to pass legislation to define, measure, and report on current primary care spending, and increase the proportion of the health care dollar that goes to primary care services across all payers.
“New York’s underserved communities have a pressing need for primary care, yet the providers and institutions that serve them have been unable to sufficiently sustain, expand, and improve services due to systemic inequities and drastic undervaluing of primary care services,” said State Senator Gustavo Rivera, Chairman of the Senate Health Committee and bill sponsor. “The goal of this bill is to create a roadmap for New York State to adequately reinvest in primary care in an effort to make it more accessible and affordable, which is crucial to improving health outcomes across the State, especially in the communities that were hardest hit by the COVID-19 pandemic.”
“Expanding primary care is critical prevention and keeping people healthy and avoiding more dangerous and expensive complications down the line,” said Assembly Health Committee Chair Richard N. Gottfried. “Our health care system — including in New York — seriously shortchanges primary care, which increases overall health care costs. And patients benefit when they have regular and consistent relationships with primary care practitioners. The primary care commission and spending targets will help New York correct the imbalance and build access to community-based primary care.”
Many of the neighborhoods with high rates of COVID-19 infections and poor primary care access are low-income neighborhoods with residents who are predominantly people of color and who experience high rates of chronic disease. Increased access to primary care is the first line of defense for these communities in the face of the ongoing COVID-19 pandemic as well as future disease threats.
Investment in primary care has vast economic benefits, including improved health outcomes, better health system efficiency, and increased health equity. Health systems that are oriented towards primary care simply function better. Yet, it is estimated that as little as 5% of U.S. health care spending goes toward primary care. New York currently spends more per capita on health care than the national average, but consistently ranks below many other states in key health indicators. This is indicative of a lack of access to and an underinvestment in primary care.
Primary care is often a patient’s first point of contact with the health care system, playing a critical role in preventing, identifying, and treating illnesses before they become chronic conditions. Research shows that an increase of just one primary care provider per 10,000 people can generate 5.5% fewer hospital visits, 11% fewer emergency department visits, and 7% fewer surgeries. In addition to improving health outcomes, upfront investment in primary care is cost-effective: findings from Oregon’s Patient-Centered Primary Care Home (PCPCH) Program showed that every $1 investment in primary care related to the program resulted in $13 in savings on other services.
Maura Harris, PCDC’s Policy and Advocacy Manager, noted in a recent story in Crain’s Health Pulse, “We need a mechanism to start understanding how much we’re investing in primary care and increase support for these services to keep people healthy.”
Louise Cohen, CEO of PCDC, emphasized the importance of the legislation stating, “Primary care is a cornerstone of vibrant, thriving communities and helps keep families healthy, children ready to learn, and adults able to pursue education and participate in the workforce. The passage of this bill is a crucial first step on the road to recovery from COVID-19, sustaining the primary care infrastructure, and improving the health of all New Yorkers.”
Public health advocates are calling for a stronger role for primary care to build back better a high-quality, affordable, and accessible health care system in New York. PCDC participated in a webinar with the New York State Health Foundation to highlight short- and long-term strategies related to public education and promotion; regulatory opportunities to bolster patient-centered care models; and rebalancing health care spending.
Primary Care Development Corporation
Maura Harris, Policy and Advocacy Manager