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Primary Care

Primary care providers are often the first point of contact for patients attempting to navigate a complex health care delivery system and seeking referrals to specialists. RAND has explored the increasing use of emergency departments as a primary care setting, the influence of primary care on health care spending, shared decisionmaking between patients and primary care providers, the emergence of retail health clinics, and more.

Journal Article

Tiered Cost-Sharing for Primary Care Gatekeeper Clinics

We analyze data from a long-standing tiered cost-sharing system for primary care gatekeeper clinics. We find that when choosing a primary care clinic, consumers are responsive to the clinic's tier.

Sep 9, 2021
Report

Health Services and Primary Care Research Study: Comprehensive Report

This report provides an independent assessment of the breadth, scope, and impact of health services and primary care research funded by the U.S. Department of Health and Human Services and U.S. Department of Veterans Affairs from FYs 2012 to 2018.

Jul 19, 2021
Blog

Veteran Journeys: Where Mental Health Research Meets Opera

Kenneth Wells, a psychiatrist, librettist, and composer, has written a documentary disguised as an opera. He drew on Partners in Care, a 10-year RAND-UCLA study that was one of the first to use a multisite collaborative primary care approach to treat veterans and others experiencing depression.

Jul 6, 2021
Multimedia

Digital Technologies to Improve Health and Care

John Campbell, professor of general practice and primary care at the University of Exeter, and Brandi Leach, senior analyst at RAND Europe, discuss how primary care practices can support patients' use of digital services.

Jun 18, 2021
Journal Article

Provider and Coach Perspectives on Implementing Shadow Coaching to Improve Provider-Patient Interactions

We aimed to characterize lessons and barriers to implementing shadow coaching as a mechanism to improve interactions with patients and change organizational culture.

May 21, 2021
Journal Article

Project SLIP: Implementation of a PrEP Screening and Linkage Intervention in Primary Care

The study developed and pilot-tested a PrEP screener for use in primary care clinics to help facilitate PrEP uptake. Findings suggest that brief HIV risk screening in primary care is acceptable, feasible, and shows preliminary effects in increasing PrEP referral rates.

Mar 5, 2021
Report

Primary Care Productivity: Findings from the Literature and Perspectives from a Stakeholder Panel

To advance understanding of primary care clinic productivity, the authors reviewed relevant literature and convened stakeholders to explore definitions, identify relevant tools, and establish consensus on key aspects of primary care productivity.

Feb 17, 2021
Journal Article

Association of Primary and Specialty Care Integration on Physician Communication and Cancer Screening in Safety-Net Clinics

This study aimed to describe strategies CHCs use to integrate care with specialists and examine whether more strongly integrated CHCs have higher rates of screening for colorectal and cervical cancers and report better communication with specialists.

Feb 12, 2021
Journal Article

Primary Care Physician Migration Patterns and Their Implications for Workforce Distribution

Using primary care physician practice locations, we described physician migration between 2008 and 2013. We found very little physician migration; however, among those who did change, net movement was away from rural counties and HPSAs.

Feb 12, 2021
Journal Article

Telehealth Use Among Safety-Net Organizations in California During the COVID-19 Pandemic

During the COVID-19 pandemic, visit volume at a sample of FQHCs declined modestly for primary care visits and remained stable for behavioral health visits because telehealth visits replaced in-person visits.

Feb 4, 2021
News Release

Nearly All Telehealth Appointments at Clinics for Lower-Income Americans Were Audio-Only, Raising Questions About Quality and Equity

Telehealth use has surged during the pandemic at clinics that serve lower-income Americans, which allowed the clinics to maintain access to care. But most visits have been audio-only, which may pose challenges if payers consider dropping reimbursement for such services after the pandemic.

Feb 2, 2021
Journal Article

Understanding How Health Systems Facilitate Primary Care Redesign

The objectives of this study are to understand how health systems are facilitating primary care redesign (PCR), examine the PCR initiatives taking place within systems, and identify barriers to this work.

Dec 10, 2020
Commentary

Primary Care Networks in a Time of Pandemic

Primary care networks in the UK bring together general practices and community providers to develop new services for patients and to provide better integration of health and social care services and sustainability in primary care. While still relatively new, their trajectory is likely to be influenced by COVID-19–related adaptations they have made over the course of the pandemic.

Nov 11, 2020
Journal Article

Early Evidence of the Development of Primary Care Networks in England: A Rapid Evaluation Study

In 2019, NHS England asked general practices to group into primary care networks and offer extra services to improve the health and wellbeing of local communities. This research looked at how these networks were established, what they have achieved so far and what has helped or hindered progress.

Oct 15, 2020
Report

Advancing the Development of a Framework to Capture Non–Fee-for-Service Health Care Spending for Primary Care

This report describes work conducted to understand what non-fee-for-service payment data are being collected by states and other stakeholders to support more complete measurement of primary care spending as a proportion of total health care spending.

Jul 30, 2020
Research Brief

Investing in the Future of Health Care: A Strategic Assessment of Federally Funded Health Services Research and Primary Care Research

Health services research and primary care research portfolios funded by agencies have distinct focus areas, and most overlap is complementary, but there are gaps in research, driven by the complexity and pace of change in the U.S. health system.

Jul 7, 2020
Journal Article

Eight Priorities for Improving Primary Care Access Management in Healthcare Organizations: Results of a Modified Delphi Stakeholder Panel

The panel achieved consensus on definitions of optimal access and access management, on eight urgent and important priorities for guiding access management improvement, and on 1–3 recommendations per priority. Each recommendation is supported by referenced, panel-approved suggestions for implementation.

Feb 12, 2020
Journal Article

Adolescents with Better Mental Health Have Less Problem Alcohol Use Six Months Later

Addressing mental health in primary care may be important for decreasing alcohol problems in adolescents.

Sep 19, 2019
Report

Evaluation of California's Global Payment Program: Final Report

The Global Payment Program seeks to improve health care for California's uninsured by using federal funds to make prospective payments for inpatient, outpatient, and nontraditional services. This report presents the final evaluation of the program.

Aug 22, 2019
Report

Identifying Safety-Net Resources at Health Centers to Prevent Infectious Disease Transmission Resulting from the Opioid Epidemic

This study highlights factors that affect Community Health Centers' ability to reduce infectious disease transmission related to the opioid epidemic.

Jun 18, 2019

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RAND Topic:
Primary Care

Research conducted by

RAND Health Care