Estimating Primary Care Spending in the United States: Toward a Common Method

Area of Science:

• Health Economics
• Health Services Research
• Public Health

Background:

• Tracking primary care spending in the US is hindered by a lack of standardized definitions and data sources.
• Previous efforts have been limited by methodological inconsistencies and data scarcity.

Purpose of the Study:

• To explore consistent approaches for estimating primary care spending in the United States.
• To apply a novel framework to existing datasets for a comprehensive analysis.

Main Methods:

• Utilized a recently developed framework for primary care services.
• Applied the framework to the Medical Expenditure Panel Survey (MEPS) and MarketScan datasets.
• Conducted cross-sectional and trend analyses from 2010-2021 to estimate spending per-person-per-year (PPPY) and as a percentage of total health care spending (PTHS).

Main Results:

• In 2019, primary care spending was estimated at $504 PPPY (8.07% PTHS) using MEPS and $378 PPPY (6.30% PTHS) using MarketScan.
• Primary care spending PPPY showed a steady increase from 2010 to 2021 across both datasets.
• Percentage of total health care spending for primary care exhibited minor fluctuations between 6% and 9% during the study period.

Conclusions:

• Comparable and reproducible estimates of primary care spending can be achieved with explicit definitions and transparent methodologies.
• Quantifying estimation uncertainty is crucial for accurate assessment and tracking of primary care expenditure.
• The study highlights the importance of standardized approaches for monitoring national health care spending.