HMN 2026: How 2017 to 2023 saw decrease in primary care visit rates, access in older adults

Across Medicare beneficiaries, primary care visit rates and access decreased from 2017 to 2023, and telemedicine accounted for a small proportion of visits, according to a study published online in JAMA Health Forum.

Ishani Ganguli, M.D., M.P.H., from Brigham and Women’s Hospital in Boston, and colleagues quantified trends in primary care use and examined the role of telemedicine in primary care access in a serial cross-sectional study using 2017 to 2023 100 percent claims and administrative data for traditional Medicare beneficiaries.

The researchers observed a decrease in primary care visit rates among 258,324,127 person-years from 2017 to 2023, from 2.54 to 2.27 per person-year; access declined from 61.9% to 59.8%. Virtual visits comprised 7% of primary care visits in 2023, and 14% of beneficiaries who accessed primary care did so using telemedicine.

From 2019 to 2023, there was a slight increase in disparities in access by race, geography, and income; beneficiaries in historically underserved groups based on race, geography, and income who accessed primary care were more likely to use telemedicine to do so. From 2019 to 2023, there was a decrease in primary care continuity from 0.72 to 0.65; in 2023, continuity was slightly higher for those using telemedicine for primary care.

“These results likely reflect dynamic shifts in primary care workforce and practice patterns, with important implications for Medicare telemedicine reimbursement and primary care payment reform,” the authors write.

The content is provided for information purposes only.