Ray KN, et al. - Researchers sought to evakuate trends in primary care visit rates and out-of-pocket costs, to examine variation in these trends by patient and visit characteristics, and to assess shifts to alternative care options (eg, retail clinics, urgent care, and telemedicine). They performed an observational cohort study of claims data between 2008 and 2016 for children 17 years and younger covered by a large national commercial health plan. They determined visit rate per 100 child-years for each year overall, by child and geographic characteristics, and by visit type (eg, primary diagnosis), and trends were assessed with a series of child-year Poisson models. They examined data between November 2017 and September 2019. In this cohort study, more than 71 million pediatric primary care visits were included over 29 million pediatric child-years (51% male in 2008 and 2016; 37% between 12-17 years in 2008 and 38% between 12-17 years in 2016). The data showed that, among commercially insured children, primary care visit rates decreased over the last decade. In addition, increases in out-of-pocket costs and shifts to other venues seem to reveal some of this reduction.