Total annual health care expenditures in the US doubled between 2002–2016, growing from $810 billion to $1617 billion, while the already small proportion spent on primary care declined to 5.4%. This means that approximately a nickel out of every dollar spent on healthcare went to primary care, which has been declared the ‘central function’ of any effective health system internationally. The US health care system continues to underperform relative to the health systems in other high-income countries. Insufficient investment in primary care plays a significant role, while states and countries with greater access to primary care clinicians and more robust primary care services have better outcomes and lower costs.

In a recent study, researchers used national US health care survey data to assess primary care expenditures relative to other sources of health care spending. Using Medical Expenditure Panel Survey (MEPS) data over a 14-year period, they estimated total annual expenditure from an aggregate of 10 health care subcategories, including inpatient, outpatient, office based, prescriptions, dental services, vision services, mental health, home health, emergency department, and other medical. Inpatient expenses accounted for the largest spending category with prescription spending ranking second highest, increasing from 18.6% to 23.6% between 2002–2016. In contrast, primary care accounted for only 6.5% of total expenditures in 2002 and decreased to 5.4% in 2016. On average, office and outpatient visits to primary care physicians accounted for 6.6% of total health care expenditures, including all nurse, nurse practitioner, and physician assistant expenditures that were added to primary care spending.

The results of this study bring attention once again to the many opportunities in the US to increase spending on primary care, including its beneficial effects on quality of care, access to care, and mortality.