Becoming Less Usual: Understanding the Decline in the Number of People with a Usual Source of Care 

Policy Points

•  Managed care may represent a promising pathway for increasing the number of people with a usual source of care and helping to reduce racial/ethnic and wealth disparities. 
• The benefits of having a usual source of care may result from greater engagement with the health care system and better relationships with providers. 

Abstract

Having a usual source of care (USC) — a health professional or care location where one can go if sick or in need of medical advice — is a key component of achieving better health outcomes and having a more positive experience with the health care system. Using data from the nationally representative Health and Retirement Study (HRS), this study examines recent trends (2014-2020) in the use of a USC among those age 50 and older, with a focus on racial/ethnic disparities and other socio-demographic characteristics, including type of health insurance coverage. The analysis found that people with a USC tend to be wealthier, White, and generally healthier than those without a USC. Between 2014 and 2020 there has been a decline in the use of a USC across all groups except for those enrolled in managed care. Results showed that people tend to either gain or lose a USC with major life changes, and that being a person of color was associated with higher odds of losing a USC as were decreases in income. Finally, although individuals with a USC used more health care services overall, there was no evidence that they utilized high-cost hospital services more than those without a USC. 

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