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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
The Impact of Nurse Practitioner-Led Primary Care on Quality and Cost for Medicaid-Enrolled Patients in States With Pay Parity
This retrospective cohort study evaluated the quality and cost implications of receiving primary care from nurse practitioners (NPs) compared to physicians in 14 states that reimburse NPs at the Medicaid fee-for-service physician rate (pay parity).
May 16, 2023
Journal Article
Changes in In-Person, Audio-Only, and Video Visits in California's Federally Qualified Health Centers, 2019-2022
The decline in audio-only visits from the early pandemic peak appears to coincide with the return of in-person visits rather than growth in video visits.
Apr 25, 2023
Journal Article
Methodology for a Six-State Survey of Primary Care Nurse Practitioners
To overcome the limitations of administrative data, we fielded a cross-sectional, mixed-mode (mail/online) survey of primary care NPs in six states to collect data directly from NPs on their clinical roles and practice environments.
Apr 12, 2023
Journal Article
Surveying Primary Care Nurse Practitioners: An Overview of National Sampling Frames
The purpose of this article is to provide an overview of national sampling frames that can be used by researchers interested in surveying or studying the U.S. primary care nurse practitioner workforce.
Apr 12, 2023
Journal Article
Practice Patterns, Work Environments, and Job Outcomes of Rural and Urban Primary Care Nurse Practitioners
This study compares urban and rural NPs using data from a survey of 1,244 primary care NPs in Arizona, California, New Jersey, Pennsylvania, Texas, and Washington.
Apr 12, 2023
News Release
Audio-Only Telehealth Remains Common At Many Safety Net Clinics
In August 2022, more than two years into the COVID-19 pandemic, audio-only telehealth visits still accounted for 1 in 5 primary care visits and 2 in 5 mental health care visits at safety net clinics in California.
Apr 11, 2023
Tool
CLARO Intervention User Manual: A Guide for Care Teams and Individual Practitioners
The Collaboration Leading to Addiction Treatment and Recovery from Other Stresses research study advances collaborative care treatment for patients who have opioid use disorder with major depressive disorder and/or posttraumatic stress disorder.
Mar 10, 2023
Journal Article
Screening for Opioid Use Disorder and Co-Occurring Depression and Post-Traumatic Stress Disorder in Primary Care in New Mexico
This study helps quantify the extent of diagnostic and treatment service gaps for opioid use disorder and co-occurring mental health disorders in primary care settings serving rural and socioeconomically disadvantaged patients in New Mexico.
Mar 10, 2023
Journal Article
Follow-Up Shadow Coaching Improves Primary Care Provider-Patient Interactions and Maintains Improvements When Conducted Regularly: A Spline Model Analysis
Re-coaching improved patient experience more than initial coaching, suggesting the reactivation of knowledge from initial coaching. However, re-coaching gains also eroded. Coaching should occur every 6–12 months to maintain behaviors and scores.
Mar 9, 2023
Journal Article
User-centered Design of a Scalable, Electronic Health Record-Integrated Remote Symptom Monitoring Intervention for Patients with Asthma and Providers in Primary Care
The objective of this article is to determine user and electronic health records (EHR) integration requirements for a scalable remote symptom monitoring intervention for asthma patients and their providers.
Jan 27, 2023
Journal Article
Addressing the Drivers of Medical Test Overuse and Cascades: User-Centered Design to Improve Patient-Doctor Communication
We designed a patient- and provider-facing intervention to improve medical test conversations.
Jan 27, 2023
Journal Article
Reasons Primary Care Practices Chose Patient Experience Surveys During Patient-Centered Medical Home Transformation
In 2008–2017, 15–18% of U.S. primary care practices sought or maintained patient-centered medical home recognition. We interviewed a sample of 105 of these practices to determine why patient experience surveys were chosen.
Dec 7, 2022
Journal Article
Poor Self-rated Mental Health and Medicare Beneficiaries' Routine Care-Seeking
This cross-sectional study assessed the relationship between self-rated mental health (SRMH) and infrequent routine care among Medicare beneficiaries and investigated the roles of managed care and having a personal doctor.
Nov 8, 2022
Report
A Scoping Review of Guidelines and Quality Measures to Screen for Social and Caregiver Support and Cognitive Impairment in Primary Care
The authors conduct a review to identify measures, guidelines, and tools that (1) assess social support, the need for caregiver support, and the need for referral to social services and (2) screen for cognitive impairment among high-risk patients.
Nov 2, 2022
Journal Article
Using CAHPS Patient Experience Data for Patient-Centered Medical Home Transformation
We interviewed 105 practice leaders from 294 sampled practices and used content analysis to identify themes about uses of patient experience data for practice improvement during PCMH transformation.
Oct 27, 2022
Report
Managing Urinary Incontinence for Women in Primary Care: Environmental Scan (Base Year)
The authors of this report present an environmental scan of studies that assess the dissemination and implementation of nonsurgical urinary incontinence treatments for women in primary care.
Oct 20, 2022
Journal Article
Empirically Identified Networks of Healthcare Providers for Adults with Mental Illness
We develop new measures for care coordination between primary care and psychiatric care specifically for individuals living with serious mental illness.
Aug 17, 2022
Journal Article
Impact of Telephone Triage on Access to Primary Care for People Living with Multiple Long-Term Health Conditions: Rapid Evaluation
We aimed to evaluate whether or not the increased use of telephone triage would affect access to primary care differently for people living with multimorbidity than for other patients.
Aug 12, 2022
Journal Article
Digital Facilitation to Support Patient Access to Web-Based Primary Care Services: Scoping Literature Review
This study aimed to identify, characterize, and differentiate between different approaches to digital facilitation in primary care, establish what is known about the effectiveness of different approaches, and understand the enablers of digital facilitation.
Jul 19, 2022
Journal Article
Clinical Pathway for Suicide Risk Screening in Adult Primary Care Settings: Special Recommendations
This paper describes a clinical suicide risk screening pathway for adult primary care practices. We also provide guidance to aid primary care practices in their decisions about how to implement the clinical pathway.
Jun 22, 2022

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RAND Topic:
Primary Care

Research conducted by

RAND Health Care

Researcher Spotlight

Lisa V. Rubenstein

Adjunct Physician Policy Researcher

Lisa V. Rubenstein is an adjunct physician policy researcher at the RAND Corporation and professor emeritus of medicine and public health at the University of California, Los Angeles (UCLA). She is a former Robert Wood Johnson Clinical Scholar, past president of the Society of General Internal…
Grant R. Martsolf

Policy Researcher

Grant Martsolf is an affiliated adjunct policy researcher at the RAND Corporation and a Professor at the University of Pittsburgh School of Nursing.

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