
The healthcare landscape is witnessing a transformation in patient preferences for primary care providers. The Employee Benefit Research Institute (EBRI) report highlights a declining trend in patients having a consistent primary care provider while spotlighting a notable shift: a rising inclination toward Nurse Practitioners (NPs) and Physician Assistants (PAs). This shift challenges the traditional role of physicians as primary caregivers. Factors like racial health disparities, evolving healthcare policies, provider shortages, and access barriers contribute to this changing paradigm. As patients navigate varied challenges, the healthcare landscape continuously evolves, influencing choices in accessing and maintaining consistent sources of care.
The evolving landscape of patient care providers reveals a significant trend: a departure from conventional reliance on physicians as primary care providers. The Fast Facts report by the Employee Benefit Research Institute (EBRI) underscores a dwindling percentage of patients reporting a steady primary care provider while noting a significant surge in patients turning to Nurse Practitioners (NPs) and Physician Assistants (PAs) for their primary care needs. This shift in preference towards advanced practice providers signifies a departure from established norms in healthcare, potentially reshaping how individuals access and perceive their sources of regular care.
A ‘usual source of care’ denotes the clinician or facility where individuals regularly seek healthcare services. Traditionally, this role has been attributed to primary care providers, although certain specialists, particularly those managing chronic illnesses, may also serve as a patient’s primary source of care.
The National Academies of Sciences, Engineering, and Medicine (NASEM) advocate for having a regular source of care, citing significant health benefits. Notably, individuals with consistent care sources are less likely to require emergency department visits.
However, EBRI’s report indicates a decreasing adherence to this recommendation compared to previous years, shedding light on prevalent racial health disparities.
In 2013, 79 percent of White individuals reported a usual source of care, leading among racial groups, followed closely by Black (75 percent), Asian (72 percent), and Hispanic individuals (71 percent). In the most recent data from 2020, White individuals continued to be the highest group reporting a regular care source at 74 percent, with Asian, Black, and Hispanic individuals slightly lower at 68 percent, 67 percent, and 66 percent, respectively.
While these disparities appear marginal, they might foretell further health inequities, potentially resulting in higher instances of chronic illnesses among ethnic and racial minorities.
The report delved into the types of healthcare providers patients prefer as their primary care sources, revealing a noticeable shift towards Advanced Practice Providers (APPs) over physicians. Physicians remain the most frequent choice as primary care providers, but the data indicated a decline in patient visits to doctors compared to 2013, alongside a simultaneous increase in visits to NPs or PAs.
In 2013, only 2 percent of White individuals cited NPs or PAs as their primary care source, contrasting with 12 percent in 2020. Similar increases were seen among Black and Hispanic individuals, rising from 2 percent in 2013 to 7 percent in 2020.
This evolution in preferred provider types might reflect the expanded scope of practice laws, enabling NPs and PAs to take on more primary care responsibilities, coupled with a growing presence of NPs and PAs in the healthcare workforce.
The decline in patients reporting a usual care source could also stem from changes in health insurance coverage, as suggested by EBRI. Employer-sponsored health plans often facilitate access to primary care providers. However, inadequate or absent insurance benefits may lead some patients to forego consistent care sources.
Moreover, reports, such as the 2023 findings from the National Association of Community Health Centers (NACHC), attribute the growing trend of patients without a regular care source to provider shortages, particularly in rural areas.
Several factors, including high healthcare costs and prolonged appointment wait times, further deter individuals from establishing a consistent source of care. These multifaceted challenges collectively contribute to the evolving landscape of patients’ healthcare preferences and their choices for primary care providers.
The emerging preference for NPs and PAs as primary care providers marks a noteworthy departure from traditional healthcare paradigms. The data from the Employee Benefit Research Institute (EBRI) reveals a complex interplay of factors influencing patients’ healthcare choices, including racial health disparities, policy changes, provider accessibility, and cost-related barriers. As patients navigate these multifaceted challenges, the healthcare landscape undergoes a dynamic shift, redefining the concept of usual care sources. This transformation signals a need for further exploration, policy adjustments, and healthcare initiatives to address evolving patient needs and ensure equitable access to quality healthcare in an ever-changing healthcare environment.