EB: What is the mission of the PCC?

AG/LM: The PCC is a not-for-profit multi-stakeholder membership organization dedicated to advancing an effective and efficient health system built on a strong foundation of primary care and the patient-centered medical home. Representing a broad group of public and private organizations, the PCC’s mission is to unify and engage diverse stakeholders in promoting policies and sharing best practices that support growth of high-performing primary care.

EB: Why did the PCC launch the “Better Health – Now” campaign?

AG/LM: In early 2022, the PCC partnered with the National Center for Primary Care and 39 other stakeholder organizations (including SGIM) to launch a new campaign focused on advancing the policy recommendations contained in the 2021 report from the National Academies of Sciences, Engineering, and Medicine (NASEM) on Implementing High Quality Primary Care.1 Building on the NASEM report’s call for fundamental changes in primary care payment and investment, the campaign issued the following five Concordance Recommendations:2

  1. establish pathways for primary care practices to transition from a predominantly fee-for-service model to a predominantly population-based prospective payment model coupled with ongoing investments and guardrails to ensure that patients and communities most affected by health inequities realize the benefits;
  2. overall healthcare spending in terms of ongoing payment and needed investment must be rebalanced toward primary care;
  3. primary care funding must be risk-adjusted, including for social drivers of health, and sufficient to support multidisciplinary primary care teams that can meet the needs of diverse populations, with an emphasis on providing high-quality care to disadvantaged communities;
  4. to better support patient-clinician relationships and accountability for population health outcomes, patients should be encouraged to choose a regular source of accessible, culturally centered primary care;
  5. increase Medicaid primary care payment to at least the level paid by Medicare, and fully fund state efforts to achieve this standard of payment.

EB: Why do you believe primary care is key to advancing health equity?

AC: Access to high-quality primary care has long been associated with improved health equity.3 As indicated in the PCC’s recent report on primary care being a key lever to advance health equity,4 primary care practitioners are dedicated to building relationships, thereby engendering the trust needed to mitigate inequities stemming from social drivers of health. Primary care practices can help connect patients to available health insurance, use digital health technology to enhance access to care, offer culturally appropriate care, use team-based care and community resources to address unmet social needs, and engage with the community in system-level decision-making.4

EB: What are the most important policy steps to strengthen primary care and advance health equity?

AG/LM: We recommend focusing on five major policy steps.3 The first step is to enhance payments and federal appropriations for the primary care safety net. The second is to accelerate efforts to collect self-reported race and ethnicity data in clinical practices, ideally disaggregated to reflect differences among sub-populations, and including primary language, geographic location, socio-economic status, gender identity, sexual orientation, age, and ability status. The third is to transform primary care’s fee-for-service payment paradigm by implementing the Concordance Recommendations mentioned above. The fourth is to adapt recent telehealth flexibilities to address long-term disparity reduction goals by ensuring continued coverage of these services and expanding high speed internet access for the millions of Americans currently lacking such access. The fifth is to monitor implementation and advocate for evidence-based policy changes for impacted communities using quantitative metrics with ongoing input from community members.

EB: What are the best ways for SGIM members to support the Better Health – Now campaign?

AC: I encourage members to join SGIM’s Health Policy Committee (HPC) or take advantage of the workshops, programs, and webinars organized by the HPC to educate members about health policy issues and advocacy skills. Stay alert for opportunities to respond when the HPC issues specific calls for action. Finally, I encourage members to meet and talk with the government affairs staff in their own institutions about what can be done locally to strengthen primary care and advance health equity.

References

  1. National Academies of Sciences, Engineering, and Medicine. 2021. Implementing high-quality primary care: Rebuilding the foundation of health care. Washington, DC: The National Academies Press, https://doi.org/10.17226/25983.
  2. Concordance recommendations for primary care payment and investment. part of better health—Now: A campaign of the Primary Care Collaborative. https://www.pcpcc.org/concrecs. Accessed December 15, 2022.
  3. Shi L, Starfield B, Politzer R, et al. Primary care, self-rated health, and reductions in social disparities in health. Health Serv Res. 2002; 37(3): 529-50. doi: 10.1111/1475-6773.t01-1-00036.
  4. Primary care: A key lever to advance health equity. A report by the Primary Care Collaborative and the National Center for Primary Care at the Morehouse School of Medicine. https://www.pcpcc.org/health-equity-report. Accessed December 15, 2022.

Issue

Topic

Advocacy, Health Policy & Advocacy, Leadership, Administration, & Career Planning, Medical Education, SGIM, Social Determinants of Health

Author Descriptions

Dr. Bass (basse@sgim.org) is the CEO of SGIM, Dr. Chen (andersch@uw.edu) is the Chair of SGIM’s Clinical Practice Subcommittee of the Health Policy Committee and liaison with the PCC, Mr. McNeely (lmcneely@thepcc.org) is the Director of Policy for the PCC, and Ms. Greiner (agreiner@thepcc.org) is the President and CEO of the PCC

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