Michigan Primary Care Physicians Answer Call for Access to Care, Yet Looming Shortage Persists

Analysis of a new Center for Health and Research Transformation survey of 756 primary care physicians (PCPs) delivers mostly good news when it comes to access to healthcare in Michigan. Overall, PCPs' capacity to accept new patients is high for all types of insurance. Nearly two-thirds (62%) of survey respondents said they have room to care for new Medicaid patients and 80% said they are able to see new Medicare and privately insured patients.

Recognizing that PCPs are a key component of a successful, high quality healthcare system, CHRT has been surveying the state’s primary care physicians since 2012 to track key trends in practice patterns, capacity, payer mix, and care team composition.

Other positives gleaned from CHRT’s survey results:

  • PCPs report an increase in multi-disciplinary care team members, such as care managers and nurse practitioners
  • More women are entering the medical field now than every before, and this is especially evident in primary care
  • Direct Primary Care is gaining traction as a practice model to be considered, with 4% of the state’s PCPs providing 24/7 access to care for patients who pay a monthly fee; another 23% said they are considering adopting DPC for all or part of their practice

While CHRT’s survey results indicate that primary care physicians are meeting a great deal of our state’s current healthcare needs, it also confirms concerns about our future workforce capacity. A majority of the survey respondents reported that they completed their clinical training more than 20 years ago and nearly half said they anticipate discontinuing practice in the next 10 years.

This, says the study authors, indicates that,With PCP incomes in Michigan falling behind the national average and some experts indicating a possible shortage of PCPs in the near future, policy makers may need to look to retention strategies to ensure an adequate number of providers are available to the population.”

New to the survey this year were questions regarding the potential impact of a Michigan law that, beginning in January 2020, will require able-bodied Healthy Michigan beneficiaries under the age of 63 to work or be involved in other “community engagement” activities for an average of 80 hours per month in order to maintain coverage. More than two-thirds (66%) of PCPs surveyed indicated concerns about the impact this law will have on continuity of care, 40% fear it will reduce overall patient volume, and 37% said they may need to hire additional staff to determine which patients are exempt from the requirements. PCPs are split on how they feel the requirements will impact health outcomes and the ethical issues of determining “able-bodied” status that is the basis for patients retaining or losing coverage.

The survey also highlights the increase in high-deductible health insurance policies and social determinants of health as barriers to care.

"It is pretty clear how important having a primary care doctor and a medical team available for regular checkups and preventive care is for good health,” said Marianne Udow-Phillips, CHRT executive director.