Dedicated Health Care Provider in District of Columbia

District of Columbia

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 the patient and provider build a stable, long-term relationship that is associated with several benefits, including:

• Appropriate preventive care.
• Lower health care costs.
• Better overall health status.
• Fewer emergency room visits for non-urgent or avoidable problems.
• Improvements in chronic care management for asthma, hypertension and diabetes.

According to America’s Health Rankings data, the prevalence of having a dedicated healthcare provider is higher among: 

• Women compared with men. 
• Adults ages 65 and older compared with adults ages 18-44.
• Non-Hispanic white adults compared with Hispanic adults.
• College graduates compared with those with lower levels of education; the prevalence is significantly higher with each increase in education level.
• Adults with an annual household income of $75,000 or more compared with those with lower levels of income; the prevalence is significantly higher with each increase in income level.
• Adults who have difficulty with mobility compared with adults without a disability.
• Straight adults compared with LGBQ+ adults.
• Adults who have served in the U.S. armed forces compared to adults who have not served.

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

• Expanding primary care capacity by empowering licensed personnel, including nurse practitioners and physician assistants, to provide more care.
• 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. 
• Reorienting health care systems to encourage patients to use primary care for new symptoms instead of seeking specialists with low-impact and high-cost procedures, which will also encourage capital investment in primary care.
• Reducing barriers to care such as lack of health insurance, high cost of care, poor geographic availability of services and lack of culturally competent care.

Healthy People 2030 has an objective to increase the proportion of individuals with a usual primary care provider.

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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.

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.

Kominski, Gerald F., Narissa J. Nonzee, and Andrea Sorensen. “The Affordable Care Act’s Impacts on Access to Insurance and Health Care for Low-Income Populations.” Annual Review of Public Health 38, no. 1 (March 20, 2017): 489–505. https://doi.org/10.1146/annurev-publhealth-031816-044555.

Winters, Paul, Daniel Tancredi, and Kevin Fiscella. “The Role of Usual Source of Care in Cholesterol Treatment.” The 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.