Low pay in primary care is leading to a care crisis in New Jersey

A report looking at primary care in New Jersey found that a shortage of primary care doctors poses a significant risk to residents.

Co-authored by Alfred Tallia, chair of the Department of Family Medicine and Community Health at Rutgers Robert Wood Johnson Medical School, the report found that a shortage of primary-care doctors poses a significant risk to residents of the United States, with New Jersey facing even more dire consequences because of poor pay.

The report found that patients often wait months for non-emergencies while others struggle to find a doctor who is taking new patients. Care for minor ailments is being delayed until they become a bigger problem.

The root cause of the shortage, according to the report, is primarily financial. Primary care doctors in the U.S. earn considerably less than specialists, leading to an insufficient number of primary-care professionals relative to specialists. The situation is exacerbated in New Jersey, where primary-care doctors face even lower incomes compared to other states, prompting many to leave the state, resulting in a more severe shortage.

Despite the proven benefits of primary care in reducing mortality, serious health conditions, and health care costs, funding for primary care remains insufficient, particularly in New Jersey. The report, titled "Primary Care in New Jersey: Findings and Recommendations to Support Advanced Primary Care," reveals that less than a third of practicing physicians in the U.S. provide primary care, compared to over half in other developed countries.

New Jersey, in particular, underspends on primary care compared to other states, ranking 48th out of 50 in primary care spending. Medicaid in the state pays primary-care doctors only half of what Medicare pays, contributing to the exodus of trained professionals from the state. The report suggests that New Jersey needs to take immediate action to address the crisis.

The key recommendations in the report include:

Raise medicaid reimbursement rates: Increase Medicaid reimbursement rates for primary care to Medicare levels, and direct Medicaid Managed Care Organizations to follow suit.

Shift compensation models: Utilize regulatory powers to shift doctor compensation from the traditional fee-for-service model to an advanced primary-care model, emphasizing keeping patients well rather than just treating them when sick.

Improved data tracking: Better track caregiver numbers and medical expenditures, using the data to monitor improvements and address shortcomings.

The report emphasized the urgency of implementing these recommendations to alleviate the shortage, drawing parallels with efforts in other states, such as Oregon, Massachusetts, and Rhode Island, that have successfully mitigated primary care shortages by adjusting reimbursement rates.

The report concludes that addressing the primary-care shortage is crucial for New Jersey residents to have easy access to health care, enabling them to lead longer and healthier lives. The proposed measures aim to bring New Jersey's primary care practices in line with countries where health care outcomes are significantly better.