Increasing Access to Primary Care Through Employer-Sponsored Health Insurance

There are approximately 295,000 primary care professionals serving the healthcare needs of Americans. That includes roughly 209,000 practicing primary care physicians, 56,000 nurse practitioners (NPs) and 30,000 physician assistants (PAs).

Most of us have at least one or two visits each year with our primary care physician (PCP). They give us advice for managing our day-to-day health needs, teach us ways to make better decisions about our health to prevent disease, recommend vaccines and preventive screenings, treat various health problems and help manage chronic diseases. If a patient needs care that a PCP doesn’t provide, that doctor can refer the patient to a specialist.

Officially, the American Academy of Family Physicians (AAFP) defines primary care as the provision of integrated, accessible healthcare services by physicians and their healthcare teams who are accountable for addressing a large majority of personal healthcare needs, developing a sustained partnership with patients and practicing in the context of family and community.

The Importance of Primary Care

The care provided by PCPs is more beneficial than you might think. Not only does research show that access to primary care is associated with positive health outcomes, but adults in the United States who regularly see a primary care physician have 33 percent lower healthcare costs and 19 percent lower odds of dying prematurely than those who see only a specialist.

A report from the National Academies of Sciences, Engineering and Medicine (NASEM) concluded that primary care is the only medical discipline where a greater supply produces improvements in population health, longer lives and greater health equity. There’s even evidence that quality primary care translates into healthier, happier patients. Also, adults with primary care are more likely to fill more prescriptions and receive recommended preventive services such as flu shots, blood pressure screenings and cancer screenings.

Primary care is critically important for people with low-incomes, especially those who have a chronic disease. Six in ten adults in the U.S. have a chronic disease, and four in ten have two or more. Not only does chronic disease directly impact quality of life and result in morbidity and disability, but it also represents a huge financial burden to the U.S. healthcare system. Approximately 90 percent of the nation’s $3.5 trillion in annual healthcare expenditures are spent on treating chronic conditions.

Obstacles to Quality Healthcare 

That’s the good news. The bad news is that there are multiple barriers that keep some Americans from accessing quality healthcare. Cost of care is at the top of that list, and lack of insurance isn’t far behind. These and other problems were outlined in a recent Washington Post article titled “Primary care saves lives. Here’s why it’s failing Americans.

Other challenges that prohibit patients from accessing care include lengthy appointment wait times, limited appointment availability and office hours, provider shortages, lack of transportation, language barriers and even racial bias. If and when these issues aren’t addressed, patients are at increased risk for gaps in care, a lack of preventive care, poor management of chronic disease and worse health outcomes.

How ESI Improves Employee Access to Primary Care

Key to promoting increased access to primary care is health insurance. Many Americans have access to care through employer-sponsored insurance (ESI). Almost 155 million non-elderly people in the U.S. — 70 percent of employees, 53 percent of children and 36 percent of nonworking adults — are covered by ESI. This type of health insurance is offered to employees and their dependents (and in most cases, spouses) as a benefit of employment.

Health insurance is second only to wages as part of employee compensation, ranking higher than paid vacation or sick leave, retirement savings plans and dental insurance. According to a survey by the Society for Human Resource Management (SHRM), 90 percent of employers rank health as the benefit their workforce values the most.

As noted by the American Hospital Association (AHA), health insurance coverage offers numerous benefits by:

  • Reducing financial strain on individuals, families and communities
  • Incentivizing appropriate use of healthcare resources
  • Helping individuals access prescription drug therapies
  • Reducing annual out-of-pocket spending
  • Improving employee productivity
  • Helping direct individuals to the most appropriate site of care
  • Assisting patients in more easily obtaining an early diagnosis and treatment
  • Improving access to behavioral health and substance use disorder treatment

Businesses that offer ESI remain more competitive with other companies in their industry and increase the odds of retaining their workforce by the financial security and better work-life balance those health benefits provide. Ninety-six percent of employees view their health insurance as either “extremely” or “very” important to them, and the majority of employees enrolled in ESI are satisfied with the coverage of their plan.

Portrait of factory worker in protective equipment holding thumbs up in production hall.

Some employers don’t realize the tax advantages they gain by offering ESI to their employees. For example, employer-paid premiums for health insurance are exempt from federal income and payroll taxes. Small businesses with fewer than 25 FTEs may be eligible for a tax credit for purchasing health insurance for their employees.

How StenTam Employer Services Can Help 

With StenTam Employer Services, you’ll receive access to best-in-class, enterprise-level health insurance products, tips on tax incentives and programs to help you maximize your benefits and tools to help you combat rising health insurance costs. Get a quote now to see how affordable it is to get a comprehensive benefits strategy tailored to your business.

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