Why It Matters
Indiana is falling behind the rest of the nation in primary and preventative care access, according to a new report that highlights significant gaps in physician availability, routine screenings, and pediatric wellness visits. The findings carry direct consequences for Hoosier families, employers, and state lawmakers working to reduce rising healthcare costs across Indiana.
Experts say expanding investment in front-end care — including primary care physician availability and routine preventive services — could reduce costly emergency department visits and late-stage disease treatment, ultimately improving both public health outcomes and economic productivity in the state.
What Happened
The Center for Health Policy at the Richard M. Fairbanks School of Public Health at Indiana University-Indianapolis released a report Monday commissioned by the Indiana Business Health Collaborative examining Indiana’s standing in primary and preventative care relative to neighboring states and national benchmarks.
The report found Indiana trails Ohio, Michigan, Illinois, and the national average across multiple key healthcare metrics, including the number of practicing primary care physicians per capita, routine cancer screening rates, and annual pediatric wellness visit completion rates.
Beth Lock, CEO and executive director of the Indiana Business Health Collaborative, said the data points to a systemic underinvestment at the front end of the healthcare system — the stage where early intervention has the greatest potential to improve outcomes and reduce long-term costs.
“Indiana has taken important steps, but we are still underinvesting in the front end of care — where the greatest impact can be made,” Lock said in a news release. “For employers, this shows up in higher costs, more complex conditions and a workforce that isn’t as healthy as it could be.”
The report notes that Indiana’s primary care physician shortage is being compounded by an aging physician workforce and fewer medical residents choosing to enter the primary care specialty, creating a supply pipeline problem that could worsen over time without deliberate intervention.
By the Numbers
The report documents several measurable gaps between Indiana and comparable states and national figures:
- 66 per 100,000: The number of primary care physicians per capita in Indiana, compared to a national average of 75 per 100,000 residents.
- 6%: The share of employer-sponsored healthcare spending in Indiana that goes toward primary care, far below the 30% national average.
- 77%: The percentage of Indiana children who complete their recommended annual wellness visits, trailing national peer states in pediatric preventive care.
- 80%: The share of Indiana adults who attended a routine checkup within the past year as of 2024, up from 77% in 2018 and modestly above the national average of 78%.
- Indiana also lags peer states in routine preventive services including cervical cancer screenings, where early detection is directly linked to improved survival outcomes.
Zoom Out
Indiana’s challenges with primary care access reflect a broader national pattern. The United States has long grappled with an uneven distribution of primary care physicians, particularly in rural and lower-income communities, where patients are more likely to rely on emergency departments for conditions that could be managed through routine care.
Nationally, the Association of American Medical Colleges has projected a shortage of between 20,000 and 40,000 primary care physicians by 2036, driven by an aging population and physician retirements outpacing new entrants into the specialty. States like Indiana, which already fall below the national average in physician availability, are expected to feel those pressures more acutely.
The gap between Indiana’s 6% employer-sponsored spending on primary care versus the 30% national average is particularly notable. Health policy researchers have consistently found that greater investment in primary care correlates with lower overall healthcare spending, fewer hospitalizations, and better management of chronic conditions such as diabetes, hypertension, and heart disease.
Several states have implemented primary care investment mandates or legislative requirements for insurers to allocate a minimum percentage of spending toward primary care services. Indiana has not yet adopted such a requirement.
What’s Next
The Indiana Business Health Collaborative released the report with the stated goal of informing ongoing legislative and employer-level discussions about healthcare cost containment in Indiana. State lawmakers have been actively engaged in efforts to address rising medical costs, and the report is intended to position primary care investment as a practical component of that broader policy agenda.
Lock indicated that strengthening primary care access and expanding preventive services represent actionable near-term steps for both policymakers and private employers who administer health benefits. No specific legislation tied directly to the report’s findings has been introduced as of publication.
The Indiana Business Health Collaborative is expected to use the report’s findings to engage lawmakers, insurance stakeholders, and healthcare systems in discussions about restructuring how primary care is funded and prioritized across the state.