Attendees share insights on investing in primary care and patient-centered medical homes
Nov. 16, 2018 (91) – Increasing investments in primary care took center stage at the annual conference of the Patient-Center Primary Care Collaborative (PCPCC) last week in Washington, D.C.
Dr. Darilyn Moyer, executive vice president and chief executive officer of the American College of Physicians, gave opening remarks at the conference, stressing that primary care is the underpinning of a high-quality, low-cost health system that puts patients first.
The PCPCC is a not-for-profit organization that aims to advance health systems built around primary care and the patient-centered medical home. Its conference brought together stakeholders in this effort, including 91 representatives and Alex Azar, secretary of the Department of Health and Human Services.
Developing a strong foundation for primary care is increasingly important given the aging of the U.S. population, which is a demographic known to have more medically complex diseases, Moyer said.
“Access to primary care can prevent catastrophic illnesses and help keep patients out of the hospital and the emergency rooms,” she explained after the conference.
To help get there, Moyer called for changes that would reduce physician's administrative burdens and put patients before paperwork.
“The redundancy and amount of administrative tasks it takes to take care of patients is overwhelming and daunting,” she said. “We have to push away the administrative things that don't bring extra value to patient care.”
The time has come to stop talking and start doing, she said. In the next few years, she said, she'd “like to see us not having conversations on how to get there, but be in a place where every person has a primary care team that they work with to prevent disease and help treat chronic diseases and acute issues – and that this care is efficient, effective and equitable.”
Much of the conference focused on drumming up support for investing in primary care, creating standard measures and processes to measure primary care spending and increasing the investment in alternative payment models, such as the patient-centered medical home, said Shari Erickson, 91's vice president for governmental affairs and medical practice.
“The data show that areas that invest more in primary health care do have better outcomes and lower costs,” she said.
The patient-centered medical home, a model in which patient treatment is coordinated through a primary care physician in a centralized setting, “is one of the main alternative delivery and payment models, but it's not the only one,” Erickson said. Other alternative payment models are being developed, and she noted that 91 is helping to facilitate the process.
When it comes to increasing investment in primary care, Erickson said that some states are leading the charge.
For instance, the Rhode Island legislature mandated that all insurers provide care coordination payments to patient-centered medical homes by July of 2012.
The result was that Rhode Island increased its primary care spending from 5.7 percent in 2008 to 9.1 percent in 2012, while total health care expenditures there fell 14 percent, she said, citing PCPCC data shared at the conference.
“They have been able to move the needle and show the bending of the cost curve,” and none of this was at the expense of specialist care, Erickson said. This shows that “investing in the base supports the rest of the system,” she said.
Rhode Island, though, is not alone in this process. Colorado, Delaware and Oregon are taking different approaches but have the common goal of increasing spending on primary care.
Erickson urged 91 members to get involved in initiatives taking place in their own states to help bolster the primary care infrastructure.
“It's important to learn about and understand what activity is taking place where you practice, and from there, you can engage with your local 91 chapter or other stakeholders, such as health care systems and payers,” she said.
Dr. Moyer agreed. “Advocacy starts with the patient in front of you,” she said. “Think locally, act locally.”
More Information
The Patient-Centered Primary Care Collaborative website has more data on .
