Strengthening Primary Care by Meeting People’s Needs

Primary care is essential to achieving better health outcomes and reducing health disparities. Consistent access to primary care leads to better overall care, more coordination among health services, improved outcomes, and lower costs. However, the way people experience primary care varies and there are persistent barriers to access, especially for underserved populations. To better understand how people view and use primary care, we conducted a national poll of more than 3,000 adults followed by two focus groups where we prioritized understanding the experiences of people of color, people living in rural areas, and younger adults.

People Value Primary Care but Face Persistent Access Issues

People value having a regular primary care clinician. More than eight of 10 (83%) of respondents said they highly prioritize having a regular primary care clinician; more than half (52%) say it’s a top priority. In focus groups, patients said they value primary care particularly when clinicians treat them as a whole person and address their overall well-being rather than focusing solely on symptoms.

Despite its benefits, primary care remains out of reach for many, leaving some to feel the system is not working for them. More than two-thirds of people reported seeing a clinician in the past two years for routine exams (67%) and prescription refills (63%), but there are still significant gaps in accessing care. One-fourth of adults who haven’t received care cited cost as a primary barrier—a challenge that disproportionately affects younger people, rural residents, and communities of color.

Cost and Access Barriers Impact Young Adults’ Use of Primary Care

Young adults in their 20s and 30s face financial barriers to accessing primary care due to lower incomes, higher insurance costs, and limited coverage. Focus groups revealed that even those with insurance are deterred by their fear of high out-of-pocket costs, making routine visits feel unattainable. Young adults also reported lower satisfaction with their primary care experiences compared to older adults who are more likely to have established long-term relationships with their clinicians. Ninety-one percent of older adults (ages 61–79) are more likely to prioritize primary care vs 71% of Gen Zers (ages 18–29), be satisfied with their care (94% vs 87%), and be satisfied with their coverage (95% vs 52%).

Focus groups revealed that while younger adults often prioritize speed and convenience when trying to access primary care appointments, they find themselves foregoing convenience because they value primary care’s role in prevention and overall health.

Cultural Responsiveness Is Key to Building Trust with Communities of Color

Race and ethnicity significantly influence how people experience primary care. People of color report lower access to — and satisfaction with — primary care services. In our 2024 polling we observed that American Indian and Alaska Native/Asian American and Pacific Islander (AIAN/AAPI), Hispanic, and Black populations were less likely than white populations to have received primary care services such as routine physicals, prescription refills, immunizations, and preventive screening tests in the past two years.

Finding a clinician who understands cultural context can be critical. Our poll found that 77 percent of Hispanic respondents, 73 percent of Black respondents, and 72 percent of AIAN/AAPI respondents want clinicians who can relate to their culture, language, or life experiences. Finding primary care clinicians who can offer culturally responsive care can build trust and improve health outcomes. Prioritizing the hiring of diverse clinicians and offering cultural competency training can help in this regard.

Rural Communities Face Unique Challenges

People living in rural areas encounter significant barriers to receiving primary care, including clinician shortages, long travel times, hospital closures, and costs. Poll findings show that 32 percent of rural adults skipped primary care due to cost — 11 percentage points higher than their urban counterparts. Transportation barriers may also play a role in accessing care.

The closure of rural hospitals and clinics further limits access to primary care in these communities. Telehealth services can help, but they are not a comprehensive solution. Rural residents need more localized options to ensure consistent, reliable access to care.

Building a Patient-First Primary Care System for All

To ensure that primary care works for everyone, it is essential to address the interconnected barriers related to cost, access, and trust. This means creating systems that prioritize patient outcomes over the number of services provided and incentivizing quality care to encourage clinicians to build meaningful, lasting relationships with patients. Policymakers also must focus on ensuring care is affordable and accessible in every community, from urban centers to rural areas. By addressing the specific needs of different populations — particularly young adults, communities of color, and rural residents — we can build a more equitable primary care system that supports all individuals.

Ultimately, primary care should be about more than having a doctor nearby. It should ensure people have access to clinicians who understand their unique needs and circumstances, foster trust, and deliver holistic, culturally responsive care. By investing in these changes, we can create a health care system that improves outcomes and reduces disparities for everyone.