Primary care, reimagined: Workforce and care model innovation in a modern age
Primary care is meant to serve as the first point of contact for prevention, chronic disease management, and referral to specialist care. In the United States, however, persistent underinvestment in this layer of the health system is contributing to avoidable costs elsewhere in care delivery.
While other OECD countries allocate roughly 13 percent of health spending to primary care, the United States spends only 5 percent. This structural imbalance has measurable consequences: in 2017 alone, an estimated 3.5 million potentially preventable inpatient stays cost the US health system approximately $33.7 billion. When patients lack timely, continuous access to primary care, conditions such as uncontrolled diabetes, respiratory illness, and cardiovascular disease are more likely to progress to the point of requiring higher-acuity, higher-cost intervention.
To examine this gap, the McKinsey Health Institute, in collaboration with West Health, developed the Primary Care Access and Capacity Explorer, an interactive model comparing the true demand for primary care against projected workforce capacity across US states through 2050. The tool allows users to test how specific interventions — workforce expansion, care-model redesign, and productivity improvements — could narrow the access gap and reduce downstream costs.
The analysis reinforces a broader theme in prevention economics: investment upstream, in accessible and continuous primary care, reduces reliance on costlier, reactive care downstream.
