Indianapolis, Indiana – A new statewide report suggests Indiana could see better health outcomes and lower health care costs by making targeted investments in primary and preventive care. The analysis, released by the Center for Health Policy at the Indiana University Richard M. Fairbanks School of Public Health at IU Indianapolis, argues that strengthening these front-line services would not only improve patient health but also support the state’s long-term economic competitiveness.
The report, titled Increasing Primary Care and Preventive Care Utilization in Indiana: A State-Level Approach, was commissioned by the Indiana Business Health Collaborative. It offers Indiana-specific data and policy recommendations aimed at lawmakers, employers, insurers, and health system leaders who are grappling with rising health care costs and uneven health outcomes across the state.
Researchers found that Indiana continues to underinvest in primary and preventive care compared to neighboring and peer states. This gap, the report says, contributes to higher rates of avoidable emergency room visits, increased hospital use, and worse outcomes for many residents—especially those in rural areas and underserved communities.
“Primary care and preventive care are widely recognized as foundational to a high-performing health system, yet Indiana continues to underinvest in these areas,” said Aparna Soni, associate professor of health policy and management at the Fairbanks School. “The evidence is clear: When states and payers strengthen primary care, patients experience better outcomes, and health systems rely less on avoidable emergency and hospital care. Total spending trends become more sustainable over time.”
The report draws on national peer-reviewed research along with comparisons between Indiana and similar states. It examines trends in the primary care workforce, overall health spending, and the use of recommended preventive services such as screenings, vaccinations, and routine checkups. The analysis also evaluates which policy and payment strategies have proven most effective in increasing access to primary care.
Among the key findings, researchers noted that patients who use primary care more consistently tend to experience better quality of care and improved health outcomes. Increased use of primary care is also linked to fewer avoidable emergency department visits, which are among the most expensive forms of care. Over time—typically within 12 to 36 months—states that strengthen primary care see slower growth in total health care spending due to reduced reliance on acute and specialty services.
The report also highlights improvements in patient experience, particularly for rural residents, low-income populations, and people with complex health needs. Team-based and well-coordinated care models were found to be especially effective in addressing these gaps. According to the findings, the strongest results occur when better financing is paired with thoughtful benefit design, data sharing, and patient engagement strategies.
Employers, the report notes, have a direct stake in these outcomes. Rising health care costs affect wages, hiring, and business growth, making workforce health a key economic issue for the state.
“Employers across Indiana feel the impact of rising health care costs every day,” said Luke Messer, chief executive of the Indiana Business Health Collaborative. “This report provides a clear, evidence-based roadmap for how smarter investments in primary care can improve workforce health while bending the cost curve. Strengthening primary care isn’t just good health policy; it’s a competitiveness issue for Indiana’s economy.”
To address the challenges, the report outlines several strategies that could meaningfully expand access to primary and preventive care in Indiana. These include expanding health insurance coverage, increasing support for federally qualified health centers and community clinics, and broadening scope-of-practice rules for advanced practice providers. The authors also recommend investing more heavily in graduate medical education, particularly in high-need and rural areas where provider shortages are most acute.
Other strategies focus on reducing barriers for patients. These include providing paid sick leave, lowering or eliminating out-of-pocket costs for high-value preventive services, and increasing reimbursement rates for primary care providers. The report also supports wider adoption of value-based or hybrid payment models that better support primary care teams and reward coordination rather than volume of services.
Patient engagement is another critical factor. Simple reminders and outreach efforts, often called “nudges,” were found to be effective in increasing the use of preventive services when combined with accessible care and affordable benefits.
At the same time, the report cautions against relying on certain popular approaches that have shown limited impact. Workplace wellness programs, high-deductible health plans, and some forms of virtual primary care were found not to increase primary or preventive care use and, in some cases, may lead to unintended negative effects.
“Indiana doesn’t need to spend more on health care overall to see better results,” Soni said. “The evidence shows that spending smarter, by investing in primary care and prevention, can deliver meaningful benefits for patients, employers and taxpayers alike.”
The report was co-authored by Nir Menachemi, dean and professor at the Fairbanks School, along with project team members Andrea Renzi-Burns and Lindsey Sanner. Together, the authors emphasize that while no single solution will fix Indiana’s health system, a focused shift toward primary and preventive care could produce measurable improvements within just a few years.
As policymakers and business leaders look for ways to control costs without sacrificing quality, the report positions primary care investment as a practical and evidence-backed path forward—one that could lead to healthier Hoosiers and a stronger state economy.
