March In-The-Know

Executive Perspective: The Power of Primary Care

Primary care has historically been the cornerstone of an effective healthcare system, providing the foundation for better population health, greater equity, and lower costs. However, younger generations, and especially millennials, are engaging less with primary care physicians (PCPs). As these employees make up an increasing share of the workforce, their declining health status presents growing implications for employers.

Health Action Council’s white paper “ Managing tomorrow’s cost today a generational and gender lens on workforce health” analyzed member data across a range of health needs, engagement levels, and care delivery preferences. The conclusion was that when members connect consistently with primary care providers (PCPs), employers see lower catastrophic costs and better clinical compliance.

The Cost Impact: Why Action is Needed

Employers face two main challenges: declining population health and rising healthcare costs across all age groups. For healthcare consultants and brokers advising employer groups, primary care is a highly effective, yet often underused, tool to improve outcomes and manage costs.

Catastrophic care—claims exceeding $100,000 annually—drives much of this cost growth. These high claims frequently stem from unmanaged chronic conditions. The Centers for Disease Control and Prevention (CDC) reports that 90% of the nation’s $4.5 trillion in annual healthcare spending is tied to chronic and mental health conditions.

Current trends show the urgency of this issue:

• Catastrophic care spend increased 37% between 2020 and 2025.
• Younger generations face faster cost growth than older cohorts.
• Chronic conditions among Millennials and GenZ appear earlier and with greater severity.

How You Can Help: Guide employers in segmenting their population by generation, gender, claims experience, and utilization patterns to pinpoint where chronic conditions are emerging, accelerating, or going unmanaged. Layer in predictive analytics, when available, to surface members at risk for avoidable escalation. Then work to build earlier, more targeted intervention strategies that can improve outcomes and reduce future high-cost claims...

Primary Care as a Cost-Control Engine

Primary care directly influences the total cost of care. Data shows that having a consistent person or place for medical attention dramatically improves both clinical and financial outcomes:

• Members engaged with a PCP for 3+ years have 27% lower catastrophic care costs on average.
• PCP-engaged members under age 40 have 5% lower overall spend.
• They experience 15% fewer ER and urgent care visits.
• They have 63% fewer hospital admissions.

Primary care serves as the first point of contact for non-emergent issues, the front for early detection, and a critical resource for effective medication management. Early detection is key for delaying or avoiding higher treatment costs due to late diagnosis. With early screenings, for example, access to primary care increases the likelihood of timely cancer screenings by nearly 30 percentage points for mammograms and 20 percentage points for colon cancer screenings.

The Hidden Cost of Disconnected Care

Convenient options like urgent care and virtual visits improve access, but they can fragment care when disconnected from a primary provider. The share of telemedicine users who do not see a PCP has steadily increased - from 25% in 2020–2021 to 30% by 2024–2025. At the same time Members using virtual care without a PCP cost nearly 2.5x more than those anchored in primary care ($240 vs. $97 PMPM).

Without a PCP relationship, members tend to make less informed decisions about their health and show lower levels of clinical compliance. This combination increases their risk of developing more costly chronic conditions. In short, as risk level rises, PCP engagement is critical for condition management and better outcomes.

How You Can Help: Make primary care provider selection and engagement a priority. Help clients educate employees on the value of having an established PCP relationship and make PCP selection easier during onboarding and open enrollment through navigation tools and other decision-support resources. Where appropriate, encourage strategies that expand access to primary care, including onsite and near-site health centers.

Actionable Strategies for Brokers and Consultants

When members skip primary care, conditions worsen, and reliance on expensive interventions grows. Primary care must act as a core strategy, not a passive benefit. The following steps can help operationalize primary care for your employer clients:

• Prioritize PCP Engagement: Simplify PCP selection during open enrollment.
• Connect Virtual Care: Use telehealth as a gateway to establish long-term PCP relationships, encouraging a combination of in-person and virtual care visits.
• Align Benefit Plans with Prevention: Encourage 100% coverage of preventive services and actively encourage annual wellness visits.

Primary care is foundational to an employer’s healthcare strategy. By shifting the focus to strong provider relationships, you can help your clients reduce catastrophic risk, lower the total cost of care, and improve the member experience.

Sources

• Health Action Council & UnitedHealthcare. Managing Tomorrow’s Cost Today (2026)
• National Academies of Sciences, Engineering, and Medicine (2021). Implementing High-Quality Primary Care
• Centers for Disease Control and Prevention (CDC). Chronic Disease Overview