Dedicated Health Care Provider - Age 65+ in Pennsylvania

Pennsylvania

Individuals with a dedicated health care provider are better positioned to receive care that can prevent, detect and manage disease and other health conditions. Having a regular health care provider helps patients and providers build stable, long-term relationships that are associated with several benefits, including:

• Higher rates of receiving preventive care.
• Lower health care costs.
• Better overall health status.
• Fewer emergency room visits for avoidable or nonurgent problems.
• Improvements in chronic care management for asthma, hypertension and diabetes.

Older adults face several obstacles to obtaining the care they need, including transitioning from employer-sponsored health care to Medicare, traveling long distances (especially for those in rural areas) and high out-of-pocket costs.

According to America’s Health Rankings analysis, the percentage of older adults with a dedicated health care provider is higher among: 

• Women compared with men.
• Black and white adults compared with Asian and Hispanic adults.
• Those with higher levels of education compared with those who have less than a high school education.

Strategies for increasing the prevalence of adults with a dedicated health care provider include:

• Increasing primary care capacity by empowering licensed personnel, including nurse practitioners and physician assistants, to provide more care, particularly in regions with health care workforce shortages. This can be done by enacting scope-of-practice laws that enable nurse practitioners to perform more primary care functions. Scope-of-practice laws lead to increases in the number of nurse practitioners per capita and higher yearly growth of the nurse practitioner workforce. 
• Making systemic and cultural improvements to the accessibility and perception of primary care in order to encourage patients to use primary care for new symptoms instead of seeking specialists with low-impact and high-cost procedures.
• Addressing care gaps caused by lack of health insurance, high cost of care, poor geographic availability of services and language barriers.

The Centers for Medicare & Medicaid Services provides a list of Medicare-enrolled physicians and health care professionals by region that can be used to find local providers.

Healthy People 2030 has several objectives for improving health care services, including:

• Increasing the proportion of people with a usual source of care.
• Reducing the proportion of people who can’t get medical care when they need it.
• Decreasing the proportion of adults who report poor communication with their health care provider.
• Increasing the proportion of adults whose health care provider checked their understanding.

Bodenheimer, Thomas S., and Mark D. Smith. “Primary Care: Proposed Solutions To The Physician Shortage Without Training More Physicians.” Health Affairs 32, no. 11 (November 1, 2013): 1881–86. https://doi.org/10.1377/hlthaff.2013.0234.

Douthit, Nathan T., Sakal Kiv, Tzvi Dwolatzky, and Seema Biswas. “Exposing Some Important Barriers to Health Care Access in the Rural USA.” Public Health 129, no. 6 (2015): 611–20. https://doi.org/10.1016/j.puhe.2015.04.001.

Friedberg, Mark W., Peter S. Hussey, and Eric C. Schneider. “Primary Care: A Critical Review Of The Evidence On Quality And Costs Of Health Care.” Health Affairs 29, no. 5 (May 1, 2010): 766–72. https://doi.org/10.1377/hlthaff.2010.0025.

Garfield, Rachel, and Kendal Orgera. The Uninsured and the ACA: A Primer — Key Facts About Health Insurance and the Uninsured Amidst Changes to the Affordable Care Act. KFF, January 2019. https://www.kff.org/report-section/the-uninsured-and-the-aca-a-primer-key-facts-about-health-insurance-and-the-uninsured-amidst-changes-to-the-affordable-care-act-how-does-lack-of-insurance-affect-access-to-care/.

Jacobson, Gretchen, Aimee Cicchiello, Arnav Shah, Michelle M. Doty, and Reginald D. Williams II. “When Costs Are a Barrier to Getting Health Care: Reports from Older Adults in the United States and Other High-Income Countries,” 2021. https://doi.org/10.26099/M7JM-2N91.

Lester, Paula E., T. S. Dharmarajan, and Eleanor Weinstein. “The Looming Geriatrician Shortage: Ramifications and Solutions.” Journal of Aging and Health 32, no. 9 (October 2020): 1052–62. https://doi.org/10.1177/0898264319879325.

Medrano, Francisco J., Alicia J. Fernandez, Rebecca L. Sudore, James N. Kirkpatrick, Natalie C. Benda, Ruth Masterson Creber, Parag Goyal, et al. “Limited English Proficiency in Older Adults Referred to the Cardiovascular Team.” The American Journal of Medicine 136, no. 5 (May 2023): 432–37. https://doi.org/10.1016/j.amjmed.2023.01.028.

Winters, Paul, Daniel Tancredi, and Kevin Fiscella. “The Role of Usual Source of Care in Cholesterol Treatment.” Journal of the American Board of Family Medicine 23, no. 2 (March 1, 2010): 179–85. https://doi.org/10.3122/jabfm.2010.02.090084.

Xue, Ying, Zhiqiu Ye, Carol Brewer, and Joanne Spetz. “Impact of State Nurse Practitioner Scope-of-Practice Regulation on Health Care Delivery: Systematic Review.” Nursing Outlook 64, no. 1 (January 2016): 71–85.https://doi.org/10.1016/j.outlook.2015.08.005.