Heart disease—not gun violence—is the leading cause of death in Prince George’s County.- Prince George’s County Council Member, Wala Blegay
On October 6, 2025, Prince George’s County Council convened as the Board of Health to address what officials described as a healthcare crisis that many residents—and even some council members—did not fully understand. The statistics presented that afternoon revealed a stark reality: one of Maryland’s most populous counties is experiencing a severe shortage of primary care physicians that has created cascading failures across its entire healthcare system.
Council Member Blegay, who chairs the Board of Health, opened the meeting with alarming data. Prince George’s County has approximately one primary care physician for every 2,000 residents. By contrast, neighboring Montgomery County—located just across the county line—has one physician for every 740 residents. The state average stands at one physician per 1,000 residents, placing Prince George’s County at nearly double the state ratio and nearly three times worse than Montgomery County.
The disparity extends beyond physician ratios. Prince George’s County has five hospitals. Montgomery County has eight. Baltimore City has 14. The numbers indicate a fundamental imbalance in healthcare infrastructure that affects every aspect of medical access in the county.
Prince George’s County Emergency Rooms Bear the Burden
The physician shortage has created a crisis within the crisis. Council Member Blegay, who spent nearly 10 years representing nurses before joining the council, initially believed emergency room overcrowding stemmed from inadequate nurse-to-patient ratios. The data revealed a more complex problem: at least 25% of emergency department visits are for primary care issues that could be addressed in outpatient settings.
According to presentations from Howard University Faculty Practice Plan, Prince George’s County residents face emergency room wait times of 10 to 16 hours—the longest in Maryland. The county records 2,945 preventable hospital stays annually and experiences avoidable emergency department visits that are 37% higher than the Maryland average. Data presented indicated that when patients receive care within a consistent physician group, they are 10 times less likely to use the emergency department, according to research published in the Annals of Family Medicine.
The emergency room has become a safety net for residents who cannot access primary care, driving up costs and producing worse health outcomes. As Council Member Blegay noted during the hearing, heart disease—not gun violence—is the leading cause of death in Prince George’s County. The county’s heart disease mortality rate stands at 176.8 deaths per 100,000 population, compared to Maryland’s rate of 169.9 per 100,000.
Geographic and Economic Disparities
Dr. Nate Apathy, an assistant professor of health policy and management at the University of Maryland School of Public Health, presented detailed geographic analysis revealing how the shortage affects different areas unevenly. Using drive-time calculations and block-group population data, his research identified specific zones of acute need.
The analysis found that approximately 13% of non-senior county residents—roughly 78,734 individuals—lack health insurance, compared to 8% statewide. The uninsured population is concentrated in Districts 2 and 3, particularly in the College Park/Langley Park area (14,300 uninsured) and New Carrollton/Hyattsville area (9,800 uninsured). Another 43,700 county residents may qualify for Medicaid, and 51,600 are potentially eligible for premium tax credits through the Maryland Health Benefits Exchange.
While proximity to primary care sites is generally adequate—most residential areas are within a 20-minute drive—availability tells a different story. The physician-to-resident ratio varies dramatically by ZIP code. Areas including Capital Heights, Accokeek, Upper Marlboro, and District Heights face ratios exceeding 3,000 residents per physician. The analysis identified District 9, southwestern District 8, and the northeastern corner of District 4 as having the worst availability relative to population.
The Inner Beltway region faces compounding challenges. According to data from the Huron Assessment referenced throughout the hearing, this area has no hospitals. Residents in this zone experience food insecurity at a rate of 52% (approximately 83,500 adults), housing quality concerns at 38% (around 60,500 adults), and transportation insecurity at 11% (roughly 17,000 adults). These social determinants correlate with health outcomes—the assessment found that a 10-point increase in social needs scores associates with 37% higher avoidable emergency department visits.
The Exodus and Economic Impact
Approximately 42% of Prince George’s County residents seek healthcare outside the county, according to data presented by multiple speakers. This exodus represents both a failure of local infrastructure and a significant economic loss. Services most commonly sought elsewhere include obstetrics (with a 75% out-migration rate), cardiovascular care, pulmonology, and general surgery.
The financial barriers to expanding primary care are substantial. Roxanne Lieber Lawrence, vice president for primary and community health at Luminous Health, detailed the economics: recruiting, hiring, and onboarding a single primary care physician costs approximately $250,000. In the first year, that physician generates an expected loss of $150,000. The total expected loss per primary care physician practicing in the county amounts to $1.6 million. Opening a new practice or expanding an existing one requires approximately $850,000.
The Huron Assessment, referenced throughout the hearing, recommends a $2.24 billion investment over 10 years to address the county’s healthcare infrastructure gaps. This includes $276 million in short-term investments (0-3 years), $983 million in medium-term investments (3-10 years), and $983 million in long-term investments (beyond 10 years).
Medicaid Access Barriers
Dr. Apathy’s presentation highlighted a critical access barrier: only 45% of primary care physicians accept new Medicaid patients, compared to 94% who accept privately insured patients. With 260,994 Prince George’s County residents enrolled in Medicaid, this disparity creates a two-tiered system where insurance coverage does not guarantee access to care.
The shortage affects medication access as well. Data presented indicated that 4,105 insured residents skip prescribed medications annually, contributing to worse chronic disease outcomes and preventable hospitalizations.
Proposed Solutions and Institutional Responses
Howard University Faculty Practice Plan presented a partnership proposal to address the shortage. Vincent Orange Jr., chief executive officer, and Dr. Leslie Jones, chief medical officer, outlined a plan to hire 20 to 40 new primary care faculty by 2030. The organization reported it can currently absorb 10,000 additional patients immediately. Notably, 40% of Howard’s faculty already reside in Prince George’s County.
The Howard model emphasizes diagnosis-based scheduling rather than time-based appointments. Under this system, patients calling the access center speak with a nurse who assigns clinical priority based on the diagnosis, enabling same-day appointments for urgent conditions. The organization has invested in AI technology that can process prescription refills within 24 hours, addressing a gap that forces some patients to wait days for medications after hospital discharge.
Dr. Leslie Jones presented case examples from social media posts by Prince George’s County residents. One mother complained of chest pain and waited three days to be seen, could not obtain a cardiology appointment within the county, and subsequently suffered a heart attack and stroke. Another expectant mother in her final weeks of pregnancy could not access care. A third patient was discharged after surgery on a Friday but could not fill prescriptions because the hospital pharmacy had closed, forcing a wait until Monday morning.
Luminous Health, which operates Doctors Community Medical Center and multiple primary care sites in the county, reported it currently employs 22 providers (including physicians, nurse practitioners, and physician assistants). Dr. Andrew McLoone, executive medical director for primary care and community health, described a team-based care model that includes pharmacists, social workers, community health workers, and diabetes education specialists. The organization recently opened offices in Greenbelt, purchased a retiring physician’s practice in Bowie, and upgraded its District Heights facility.
Luminous has embedded a social determinants of health screening platform in its Epic electronic health record system to identify barriers to care. The organization offers same-day appointments, extended-hours telehealth services, and remote patient monitoring for cardiac conditions. Dr. McLoone stated the organization aims to become a destination for diabetic care rather than relying solely on geographic convenience.
Systemic Barriers to Expansion
Council Member Harrison raised questions about land use and zoning policies that might incentivize healthcare investment. He noted that healthcare systems operate as businesses and questioned what Montgomery County does differently to attract providers. Dr. Apathy acknowledged that certificate-of-need requirements and zoning regulations oversee healthcare facility development but could not speak to Montgomery County’s specific strategies.
Council Member Adam Stanford mentioned upcoming legislation in Annapolis regarding health enterprise zones, which could spur additional health center development through targeted incentives and zoning changes.
The county’s 284 unaffiliated outpatient primary care sites outnumber system-affiliated locations. Among healthcare systems, Luminous Health operates 12 sites, MedStar Health operates 10, Children’s National Health System operates 8, and the University of Maryland Medical System operates 7. Kaiser Permanente has 5 sites, while Johns Hopkins Health System, Adventist Healthcare, and Ascension Health have minimal presence.
The Data Limitations
Dr. Apathy cautioned that available data cannot fully capture access challenges. Population-to-physician ratios do not account for wait times—information that is generally not publicly available. A physician practicing half-time would have substantial impact on availability but would appear identical to a full-time clinician in population counts. The analysis also cannot determine whether a physician is nearing retirement or how many patients they can realistically serve.
Vice Chair Orietta questioned how the analysis defined available primary care, noting that District 7 inside the Beltway has urgent care facilities but lacks primary care physicians. She reported being unable to find a primary care doctor in her district and could not deliver her child in Prince George’s County. Dr. Apathy clarified that the analysis focuses on areas where challenges are most acute, not that other districts lack problems.
Cultural Competence and Workforce Pipeline
Dr. Leslie Jones emphasized that culturally competent care produces better health outcomes. The Howard University faculty, she noted, reflect the demographics of Prince George’s County residents and understand the community’s needs. Research indicates that patients experience better outcomes when treated by physicians who share their cultural background and understand community-specific health challenges.
CCI Health Services, a federally qualified health center referenced in the hearing, focuses on developing the primary care workforce pipeline. While the organization’s full presentation was not included in the available transcript, Council Member Harrison noted that Ben Medical—likely CCI’s previous name—provides primary care for uninsured populations in southern parts of the county but was not initially visible on the geographic analysis maps.
Obesity, Diabetes, and Chronic Disease
Howard University’s presentation highlighted specific chronic disease burdens. Data showed that 50% of adults in the county have obesity, 12% have diabetes, and maternal health disparities are significant—Black women face a 67.5% obesity risk compared to 33% for Hispanic women. These chronic conditions require ongoing primary care management to prevent complications and reduce hospitalizations.
Luminous Health reported operating an extensive bariatrics program and launching remote patient monitoring for cardiac conditions, with plans to expand to asthma management. The organization aims to achieve excellence in diabetic care, positioning itself as a center of clinical expertise.
The Future of Healthcare in Prince George’s County
According to state and national health authorities, up to 299,000 Marylanders—and tens of thousands of Prince George’s County residents—face premium hikes of nearly $1,000 and coverage losses if ACA premium tax credits expire, unless Congress acts to renew the subsidies.
The Council’s Board of Health hearing represented a turning point in acknowledging the scope of Prince George’s County’s primary care crisis. Council Member Blegay noted that immediately before the healthcare hearing, the council had held a hearing on bringing another fast-food restaurant into the community—a decision she characterized as “creating the swamp that’s impacting our overall health that’s forcing us to have to look for primary care physicians to address the concerns we have.”
The data presented indicates that without substantial intervention, the physician shortage will worsen. Maryland faces a projected shortage of 1,052 doctors by 2030, with 35.8% of current physicians approaching retirement age. Prince George’s County’s higher-than-average uninsured rate may increase further in January 2026 unless Congress extends enhanced premium subsidies for health insurance, potentially triggering a 20% decline in enrollment statewide.
The proposed solutions—academic partnerships, health enterprise zones, loan repayment programs, team-based care models, and multibillion-dollar infrastructure investments—require coordination across multiple levels of government and sustained political will. The hearing made clear that the county’s healthcare crisis extends beyond statistics. It affects mothers unable to access prenatal care, heart attack victims unable to see cardiologists, and surgical patients unable to fill prescriptions. It drives residents to neighboring jurisdictions for basic medical services and transforms emergency rooms into overwhelmed primary care substitutes.
As the Board of Health adjourned, the path forward remained uncertain. What was certain, based on the evidence presented, is that Prince George’s County faces a healthcare access crisis that demands immediate, comprehensive, and sustained intervention to prevent further deterioration of health outcomes and quality of life for its nearly one million residents.