Decline in Primary Care Access Among Medicare Beneficiaries: JAMA Study Insights

A study published in the JAMA Health Forum reveals a decline in primary care visit rates and access among Medicare beneficiaries from 2017 to 2023, with telemedicine playing a limited role. Conducted by Dr. Ishani Ganguli and colleagues from Brigham and Women’s Hospital, the analysis used comprehensive claims and administrative data from traditional Medicare beneficiaries over the specified period, pointing to significant trends in healthcare access and delivery.

The study found that primary care visit rates fell from 2.54 to 2.27 visits per person-year. Access to primary care services decreased from 61.9% to 59.8%, with only 7% of primary care engagements conducted virtually. Between 2019 and 2023, disparities were noted in access related to race, geographic location, and income, with underserved groups more likely to use telemedicine. This highlights potential areas for improvement in payer strategies to enhance telehealth accessibility.

Moreover, continuity in primary care dropped from 0.72 in 2019 to 0.65 in 2023, though slightly better continuity was observed for telemedicine users. These findings have significant implications for Medicare telemedicine reimbursement policies and primary care payment structures, urging the insurance industry to consider innovations in payment models as they adapt to evolving healthcare delivery methods.