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A 11 minute read
Doctor stethoscope on arm
August 13, 2020

Primary care physicians (PCPs) are an integral part of the care continuum. These providers are on the front lines of population health management and preventative care, gaining the trust of patients and families to deliver effective, personalized treatment.

PCPs are responsible for chronic care management, specialist referrals, and evaluation for emerging health issues. Without a primary care physician, patients are at risk of receiving more serious diagnoses at later stages of illness, which can have severe impacts on care outcomes.

Below, you will find lists and details explaining both the ten most common diagnoses and ten most common procedures at primary care facilities.

What are the most common diagnoses by PCPs?

In 2019, essential (primary) hypertension was the most common primary care diagnosis, with over 27.6 million diagnoses reported. Many of the most common primary care diagnoses — like hypertension, hyperlipidemia, and type 2 diabetes — can be avoided or treated with early diagnosis and proper preventative care. If left untreated, these conditions can lead to complications like heart disease, nerve damage, kidney damage, or even increased mortality.

Top 10 most common diagnoses from primary care physicians (PCPs)

Rank

ICD-10 Code

ICD-10 Description

Total Charges

Total Diagnoses

1

I10

Essential (primary) hypertension

$2,783,557,307

27,622,848

2

E785

Hyperlipidemia, unspecified

$361,443,023

10,518,729

3

E119

Type 2 diabetes mellitus without complications

$901,539,837

8,481,532

4

Z0000

Encounter for general adult medical examination without abnormal findings

$2,380,123,162

8,146,318

5

Z23

Encounter for immunization

$426,859,081

5,677,826

6

E039

Hypothyroidism, unspecified

$267,657,779

5,258,476

7

K219

Gastro-esophageal reflux disease without esophagitis

$226,186,108

4,963,714

8

I2510

Atherosclerotic heart disease of native coronary artery without angina pectoris

$1,290,864,682

4,646,028

9

E782

Mixed hyperlipidemia

$164,055,295

4,261,902

10

E559

Vitamin D deficiency, unspecified

$118,288,013

3,969,503

Fig. 1: Physician diagnosis analytics are from Definitive Healthcare’s Medical Claims database and reflect diagnosis volumes for physicians with an internal medicine specialty. Data represents all-payer medical claims through the end of the 2019 claims year, the most recent full-year data available. All-payer medical claims data is sourced from multiple medical claims clearinghouses in the United States and is updated monthly. Accessed August 2020.

Immunizations were the fifth most commonly reported physician encounter in 2019, emphasizing the importance of PCPs in offering preventative medicine and population health management. With fewer parents opting to vaccinate their children, outbreaks of measles and mumps are occurring in more than 40 states. By providing immunizations for illnesses like the flu to eligible patients, PCPs can help curb preventable threats to population health.

What procedures are the most commonly performed PCP procedures?

Routine venipuncture (blood draw) was the most common procedure performed by primary care physicians in 2019. Many of the most common primary care procedures include diagnostic tests like this one or physical therapy procedures.
 
This fact might help to demonstrate that without access to a PCP, patients are at higher risk of developing complex medical conditions that would otherwise be preventable or treated in early stages. Patients lacking a PCP may also find recovery from traumatic physical injuries or joint problems to be a slower and more cumbersome process.

Top 10 most common primary care procedures

Rank

HCPCS Code

HCPCS/CPT Description

Total Charges

Total Procedures

1

36415

Routine Venipuncture

$190,139,418

9,181,101

2

97110

Therapeutic Exercises

$580,543,499

4,816,692

3

85025

Complete Blood Count with Auto Differential

$369,562,922

4,259,064

4

97530

Therapeutic Activities

$418,511,456

4,022,703

5

80053

Comprehensive Metabolic Panel

$720,232,958

3,821,791

6

80061

Lipid Panel

$367,414,620

3,457,903

7

83036

Glycosylated Hemoglobin Test

$202,485,810

2,929,046

8

90471

Immunization Admin

$173,306,085

2,889,261

9

93000

Electrocardiogram Complete

$173,004,962

2,509,295

10

99396

Established Patient Preventative Medicine Services

$642,697,709

2,433,262

Fig. 2: Data from Definitive Healthcare’s Medical Claims database, filtered by physicians specializing in internal medicine. Data is from calendar year 2019 (most recent complete year available). The list does not include “Office/Outpatient Visits” (HCPCS codes 9921) and “Subsequent Hospital Care” (HCPCS code 9923). All-payer medical claims data is sourced from multiple medical claims clearinghouses in the United States and is updated monthly. Accessed August 2020.

As seen in figure 1, hyperlipidemia (excess fat in the blood vessels) is the second most-diagnosed condition by PCPs. This ailment is diagnosed via lipid panels, which is the sixth most common procedure found in figure 2. Undiagnosed, hyperlipidemia can lead to an increased risk of heart attack, stroke, heart disease, and other illnesses.

Are there enough PCPs for all Americans?

Despite the importance of having a PCP, 28 percent of men and 17 percent of women reported having no personal physician in 2018. Nevada, Alaska, and Texas are the top three states with the greatest percentage of adults reporting that they have no PCP. This could be due to many factors, including physical barriers to healthcare access (such as transportation), insurance coverage, or provider shortages.

Definitive Healthcare data shows that internal medicine and family practice are the two most common physician specialties, with roughly 138,000 and 126,000 registered providers. While this may appear to be a large number of providers, industry leaders remain concerned that the demands of an aging population with a growing list of chronic health issues will outpace the number of physicians. The simplest solution moving forward is a bigger cultural push for regular preventative care for adults.

A 2019 study from JAMA Internal Medicine found that for every 10 additional PCPs per 100,000 patients, there was an associated life expectancy increase of nearly 52 daysYet, between 2005 and 2015, the density of primary care physicians dropped from 46.6 to 41.4 per 100,000 people. This decrease in available physicians impacts some regions more than others. Rural areas experienced a disproportionate loss, making an already-vulnerable population more susceptible to preventable illnesses.

To improve primary care provision, the Centers for Medicare and Medicaid Services (CMS) announced CMS Primary Cares, a new program that will reward physicians who offer advanced preventative care. The initiative offers five payment options that allow providers to take on varying levels of financial risk to improve care outcomes and lower costs. Under this new program, physicians would receive financial rewards for enhancing care management for patients with chronic illnesses — like diabetes and hypertension — and avoiding hospital or ER admission.

This is one of many steps CMS has taken to move U.S. healthcare to a value-based system.

Learn more

Looking for more details on preventative care and the outlook for primary care physicians in 2020? Watch our webinar on the 8 Top-of-Mind Trends in 2020 for Sales and Marketing to see how millennials view primary care, as well as seven other major trends to keep an eye on moving forward.


ABOUT THE AUTHOR

Tarell Morris

An English graduate and a tech nerd — I enjoy reading, writing, and getting involved with some technical nitty-gritty and design when time and opportunity allow for it. Some favorite books of mine ...


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