Primary care (PC) is an essential building block for any high quality healthcare system, and has a particularly positive impact on vulnerable patients. It contributes to the overall performance of health systems, and countries that reorient their health system towards PC are better prepared to achieve universal health coverage. Monitoring the actual performance of PC in health systems is essential health policy to support PC. However, current indicators are often too narrowly defined to account for quality of care in the complex populations with which PC deals. This article reviews a number of conceptual frameworks developed to capture PC values in robust measures and indicators that can inform policy and practice performance. Each have benefits and limitations. Further work is needed to develop meaningful primary health care (PHC) and PC measures to inform strategic action by policymakers and governments for improved overall performance of health systems.

Background: Low-value services account for $75 billion to $100 billion of U.S. health care spending. Primary care physicians (PCPs) have been conceptualized as potential gatekeepers for efforts to reduce low-value spending, but the share of low-value spending directly related to their services and referral decisions remains unclear .

Objective: To estimate the share of low-value spending on Medicare beneficiaries that is directly related to their attributed PCP’s services or referrals.

Methods and Findings: We analyzed Medicare Part B claims from a 20% random sample of beneficiaries enrolled between 2007 and 2014. The study population included beneficiaries who were …

Rural regions of the United States continue to experience a disproportionate shortage of physicians compared to urban regions despite decades of state and federal investments in workforce initiatives. The graduate medical education system effectively controls the size of the physician workforce but lacks effective mechanisms to equitably distribute those physicians.