The Importance of Strengthening Primary Care
- December 8, 2023
An ad hoc committee, with the support of the National Academy of Sciences, Engineering, and Medicine, examined the current state of primary care in the United States and developed an implementation plan to improve its quality in the report Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care. They leveraged the recommendations from the 1996 IOM report, “Primary Care: America’s Health in a New Era.”
The report emphasizes the crucial role of high-quality primary care in achieving the quadruple aim of healthcare: enhancing patient experience, improving population health, reducing costs, and improving the healthcare team experience. Despite its importance, primary care remains under-resourced, receiving only about 5% of healthcare expenditures while accounting for 35% of visits. The article highlights the decline in primary care visits and a shrinking workforce pipeline, with clinicians opting for more lucrative specializations.
The COVID-19 pandemic has exacerbated existing disparities in access to primary care, and many practices face financial uncertainty. Recognizing the significance of primary care as a public concern, the National Academies of Sciences, Engineering, and Medicine formed a committee to develop an implementation plan for high-quality primary care in the United States, building on recommendations from a 1996 Institute of Medicine report.
As defined by the committee, high-quality primary care involves whole-person, integrated, accessible, and equitable healthcare provided by interprofessional teams. The article identifies seven facilitators for achieving this vision, including appropriate payment models, effective measurement of accountability and quality improvement, digital healthcare integration, interprofessional care teams, research, leadership coordination, and supportive policy and regulations.
The implementation plan outlined in the article focuses on five objectives:
- Reimbursement for Primary Care Teams: Shift the focus from paying doctors for services to paying primary care teams for comprehensive patient care.
- Universal Access: Ensure that high-quality primary care is available to every individual and family in every community.
- Community-Centered Training: Train primary care teams where people live and work to address local needs.
- Patient-Centric Information Technology: Design information technology that serves patients, families, and interprofessional care teams, making the primary care experience more efficient and convenient.
- Scalable Solutions with Local Adaptation: Balance national needs with local fit to provide scalable solutions that address the unique needs of different communities.
By putting these objectives into action, the article suggests that the U.S. can rebuild a strong foundation for its healthcare system, ultimately improving health outcomes and promoting health equity.
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