High-quality primary care for all Americans: National Academies release plan to achieve it

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The National Academies of Sciences, Engineering and Medicine released an implementation plan May 4 for the U.S. government, recommending it provide high-quality primary care to all Americans. 

The National Academies are private, nonprofit institutions that provide independent analysis and advice, and inform certain U.S. public policy decisions.

"Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care" states that ensuring access to primary care will require reforming payment models, expanding telehealth services and supporting integrated, team-based care. Since no federal agency currently oversees primary care, the report recommends HHS establish a Secretary's Council on Primary Care, as well as an Office of Primary Care Research at the National Institutes of Health. 

Primary care is the only part of healthcare where increased supply is tied to better population health and more equitable outcomes, according to the report. Declining primary care workforce capacity is associated with a loss of 85 lives each day, the report finds.  

To achieve its vision, the committee recommends:

Reform payment models: Public and private payers should shift from a fee-for-service payment model to hybrid models. CMS should aim to boost physician payment rates for primary care services by 50 percent, and reduce the rates of overpriced healthcare services. As the largest payer in the U.S., Medicare should be prioritized for payment reform.

Increase access points: HHS should invest in the creation of new health centers, particularly in areas that are underserved or have a physician shortage.  

Design interprofessional care teams: Primary care teams should fit the needs of communities and coordinate care across multiple settings.

Support community-based training programs: Training primary care clinicians individually in inpatient settings won't adequately prepare them. HHS should support training opportunities in community, rural and underserved settings, and provide economic incentives such as loan forgiveness and salary supplements.  

Make health IT user-friendly: In the next phase of EHR certification standards, the Office of the National Coordinator for Health Information Technology and CMS should account for the user experience of clinicians and patients.

Establish accountability and effective measurement: The proposed Secretary's Council should be tasked with defining measures for high-quality primary care.  

Create a primary care research agenda: Primary care research typically accounts for less than 0.4 percent of NIH's budget. Creating a research arm at NIH would build an evidence base to guide improvements.

For the full report, click here

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