'Talk to your doctor': How primary care lowers costs, improves outcomes

Studies show that having a primary care provider (PCP) leads to better health outcomes and lower overall costs. Yet, despite the clear benefits, 100 million Americans lack an established PCP and only 53% of Premera commercial members have one.

Why it matters 

Primary care is not just the front door to the healthcare system, but also the foundation of better outcomes, lower costs, and stronger relationships.

“At Premera, we’ve seen firsthand that members with an established primary care provider experience improved preventive care, fewer emergency visits, and greater satisfaction with their health plan,” said Romilla Batra, chief medical officer, Clinical Strategy & Solutions. “When patients have a doctor who knows them, they don’t just get care—they get better.”

Challenges to overcome 

Despite the clear benefits of primary care, there are also significant hurdles:

• Barriers to access: Nationally, average wait time for a PCP appointment is 31 days. In the greater Seattle area, the average wait time is 51 days.¹
• Overuse and high cost of emergency departments (ED): In 2021, there were 107+ million ED visits in the United States with aggregate costs amounting to $80+ billion dollars and private insurance as the expected payer was almost 35%.²

Centering primary care 

Premera is tackling these challenges with a multi-year strategy that centers primary care in our benefit designs, partnerships, and member experience initiatives.

Here’s what else we’re doing

Here’s how we’re making “talk to your doctor” a tangible, affordable action for our members—and driving down costs in the process:

• Smarter plan designs
• Small group plans now offer designated PCP copays as low as $5, compared to $15+ for non-designated PCP visits.⁴ 
• Preventive Care Push
• Campaigns for cervical and colorectal cancer screenings emphasize that care starts with your PCP.

Contact your Premera producer or account representative to learn more.

1. https://www.amnhealthcare.com/siteassets/amn-insights/physician/ps-2025-physician-appt-wait-times—wp-v6.pdf
2. https://hcup-us.ahrq.gov/reports/statbriefs/sb311-ED-visit-costs-2021.pdf
3. Small group health plans with primary care provider designation are limited to the Choice and Balance PPO plans. High deductible health plans are not included.