Do you a need a primary care physician (PCP) and why is this important?

November 2, 2020
Aspire blog - Do you a need a primary care physician (PCP)?

A primary care physician, PCP for short, is the doctor you see first for most health problems. He or she makes sure you get the care you need to keep you healthy. He or she also may talk with other doctors and healthcare providers about your care and refer you to them. A PCP is a key component of both HMO and HMO-POS Medicare Advantage plans. While these plans require that you select a PCP in your provider network, this has many benefits for your overall health and well-being.

A study from JAMA Internal Medicine, a journal published by the American Medical Association (AMA), found that adults with a PCP were more likely to have routine preventive visits each year, fill more prescriptions and receive screenings. Proactive preventive care can help identify health concerns and chronic conditions earlier, especially when done by someone who knows you and your medical history. That thorough knowledge also helps with more accurate diagnoses. In addition, PCPs help patients better manage and control chronic conditions such as arthritis, depression, diabetes and high blood pressure.

Also, if a health problem arises that requires a medical specialist, your PCP can refer you the right specialist to meet your individual needs. Your PCP can also make sure that your provider is in-network, ensuring you are covered and receive the best care possible. Continuity and coordination of care between your PCP, specialists and health plan can help provide the right care in the right place at the right time.  When your specialist and PCPs work together your prescriptions are better managed.

There is a common myth that provider networks for Medicare Advantage plans are small, meaning that options for PCPs are limited. This is not the case. Standards for provider networks are set by the federal government. Over 700 doctors, many other healthcare providers and all four Monterey County hospitals are part of the Aspire Health Plan network. It is about coordinating and personalizing your care. You can use our “find a doctor” tool to search for providers using first name, last name or specialty.

Overall, having a PCP means that your care is in the hands of someone that you know and trust. If you have any questions, we’re here for you! Give us a call or leave your question in the comments section below.


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