Primary care doctors are few and far between in the US. Millions of Americans struggle to find one. And, because insurers pay so little for primary care, the number of primary care doctors is dwindling quickly. it is particularly difficult to find primary care doctors who take insurance. Karen Brown reports for KFF Health News that some primary care doctors are banding together to increase their market power and their rates.
Right now, there’s a shortage of PCPs, and projections are that, over the next decade, the shortage will only worsen. By 2036, the shortage is expected to reach 86,000 PCPs. More PCPs are retiring, and fewer physicians are becoming PCPs.
Insurers pay PCPs substantially less than specialists. In part, this explains why it can be extremely difficult to find a primary care doctor who takes insurance.
The PCPs want higher pay. Many think that getting a monthly fee for every patient–rather than being paid a fee for each service they deliver–will help increase their earnings. But, that’s only true if their patient pool does not include a lot of people in poor health.
It’s not clear at all that the solution to low PCP rates is a fee for each patient in a physician’s panel. If PCPs end up with a lot of patients with multiple chronic conditions, they will struggle to make ends meet. They should not be in the business of balancing their patient pool or avoiding people who most need costly care.
If PCPs are paid a fixed fee for each patient, people with serious conditions could be especially hard-pressed to see a PCP who takes insurance. It would be far better to increase PCP rates.
So, beware. If you have or develop multiple chronic conditions, under a fixed fee per patient revenue model, your PCPs might find that you are endangering their revenue streams and find a way to nudge you out of their practices. Moreover, if your PCPs are owned by a hospital or a private-equity firm, these corporate entities will create incentives for your PCPs to stint on your care.
Here’s more from Just Care:
- Every American needs a primary care doctor
- Six reasons you need a primary care doctor in this age of specialization
- Four questions to ask yourself about your primary care doctor
- Questions for your primary care doctor if you have Medicare
- Primary care in Medicare Advantage: A crapshoot
