The high cost of underinvesting in primary care

In the United States, we’re all too familiar with how expensive healthcare can be. Each year, costs rise while benefits shrink. Premiums go up, deductibles and copays follow, and employees end up paying more out of pocket. In fact, large employers anticipate a median healthcare cost increase of 9% for 2026. 

Amid this endless cycle of rising costs, it may sound counterintuitive to suggest that one of the best ways to lower costs is to first spend more. As we’ll explore below, targeted investment in primary care—especially when paired with navigation—can drive better outcomes and lower costs for employers and employees alike.

Underinvestment in primary care

When unpacking the $4.9 trillion the US spends on healthcare (yes, that’s trillion…with a T), it’s first important to understand that less than 5% of that total is spent on primary care. With those numbers, it seems that primary care in the US isn’t actually that primary after all. Studies show that primary care physicians are undervalued and underpaid, with large wage gaps between generalists and specialists. In 2022, the average reimbursement for a primary care visit was $259, compared to $1,092 for a gastroenterology visit.

To put these numbers in perspective, we can look at other developed countries. Fortunately, the Organization for Economic Co-operation and Development (OECD)—a group of 38 developed nations—compiles metrics on this very topic. While the US spends 16.6% of its GDP on healthcare, the OECD average is merely 9.2%. Given that the US spends nearly twice the percentage of GDP on healthcare, exploring the variances in expenditures may provide clues and opportunities for improvement here domestically.

Among the myriad of comparative data points, one stands out above all the others. As mentioned previously, in the US, we spend about 5% of total healthcare dollars on primary care. In the other OECD nations, that number averages 14.5%, nearly triple the rate domestically. Said another way, the rest of the developed world is investing a far greater proportion of healthcare dollars on primary care—and it’s paying off.

A deeper look at the US vs. OECD points to success with this larger primary care investment in terms of preventive care and outcomes. These other countries see 55% fewer avoidable hospital admissions for diabetes and 42% fewer avoidable admissions for heart failure. A strong, foundational primary care experience is essential in identifying and managing conditions such as these to prevent their escalation into more serious issues. It’s also important to note that the obesity rate in these nations is on average 40% lower. While primary care is not the only determining factor of obesity, it is an important element in health and prevention.

The value of primary care: More than just an annual checkup

You might be thinking, “This is all great data, but is it possible this is just a coincidence?” Not quite. A growing body of research shows that strong, consistent primary care directly reduces total cost of care.

A 2023 JAMA study suggests a strong correlation between visit frequency, regularity, and continuity and improved health outcomes and reduced total cost of care. This study of the Medicare population divided patients into 6 groups based on their primary care utilization patterns. Those with the most consistent utilization (tabbed “highly continuous regular”) had 52% fewer ED visits, 43% fewer hospitalizations, and 41% lower annual costs than those in the “noncontinuous irregular” category.

Another study using Veterans Affairs data draws similarly compelling conclusions. In reviewing health status and the number of primary care visits for a population of over 5 million patients across 4 years, each incremental primary care visit was correlated with a $721 reduction in annual total cost of care. This cost savings increased significantly for those in poorer health. 

In short, getting people, especially those in poorer health, on an active schedule of primary care visits is beneficial for health outcomes and costs.

The Solution: Pairing navigation with Advanced Primary Care

The data is clear: investing in accessible, proactive primary care pays off. But for employers, the challenge isn’t just funding better care—it’s helping employees find it, choose it, and use it.

That’s where navigation comes in. Even the best primary care model can’t drive results if people don’t know where to go or how to get started. Navigation helps connect employees to high-value, advanced primary care—the kind that’s integrated, preventive, and focused on whole-person health.

A strong partnership between care navigation and advanced primary care ensures that members aren’t left guessing. Instead, they’re guided toward options that offer the biggest impact for their health and wallet. Here’s what that looks like in action:

• Integration: Navigation apps and primary care work together to share insights and coordinate across benefits programs, ensuring members get connected to the right care at the right time.
• Engagement Strategy: Navigation apps use data and personalization to meet members where they are—nudging them toward high-value primary care and preventive check-ups and screenings.
• More Care Under One Roof: An integrated care team (primary care, behavioral health, health coaching, care navigators, nutritional services and other clinical services) delivering comprehensive, advanced primary care that promotes physical, mental, and social wellbeing
• Business Model: Breaking free from traditional fee-for-service payments for care and aligning incentives so providers are paid for keeping individuals healthy, not simply treating them when they are sick
• Proven Results: With navigation steering members to high-quality primary care, employers see better outcomes, higher satisfaction, and lower total costs.

The takeaway? Investment in primary care works best when it’s guided. Pairing navigation with advanced primary care helps people make confident choices, stay on top of their health, and get care that delivers value for themselves and for your organization.