Advocacy and Policy

2018 Policy and Advocacy Agenda

The Patient-Centered Primary Care Collaborative (PCPCC) engages in team-based advocacy around policy and practice changes that promote robust primary care to achieve the quadruple aim. Our policy strategy is focused on increased investment in primary care through alternative payment models that enable PCMHs and other types of advanced primary care to provide integrated, higher-value care that connects to the community.

Evidence demonstrates – and our Executive Members and Supporters believe – that comprehensive primary care is a high-value intervention that transforms our health care system.  We work to empower patients through increased access to advanced primary care, and we support clinicians by encouraging team-based care and by empowering them to deliver the care that patients need and desire.  While we engage on a variety of issues, PCPCC’s current policy focus is on allocating the resources needed to achieve advanced primary care and ensuring patient access to such care.  More specifically: 

Support Payer and Purchaser Innovations that Promote Access to Primary Care

  • Shape the legislative/regulatory environment for value-based models to ensure that access to high-value primary care is core to benefit design. (Recent studies show a decline in patient use of such care – perhaps due to financial barriers.)
  • Collect and disseminate evidence linking access to high-performing primary care to improvements in health, affordability, and workforce outcomes
  • Promote the selection of a primary care provider at enrollment, the removal of financial barriers to primary care through the reduction of copayments and deductibles for high-value primary care services, and access to Patient-Centered Medical Homes

Investment in High-Value Primary Care that Improves Outcomes and Prevents Avoidable Costs

  • Promote a standardized way to measure and report primary care spending as a percentage of overall spend
  • Collect and disseminate evidence on the impact of adequately resourced primary care models 
  • Make the case for investment in high-value primary care alternative payment models that ensure support for comprehensive, coordinated, team-based primary care with proven results
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In addition to these two advocacy-related focus areas, PCPCC will continues to convene thought leaders, develop programming, and educate in areas core to its work of strengthening advanced primary care models, including practice-level behavioral health integration, team-based and collaborative care, and patient and family engagement.

Learn more about these efforts as they develop at www.pcpcc.org or reach out the Chris Adamec, Director of Policy at [email protected].

PCPCC has long led the effort to transform primary care into a more integrated, team-based model – captured through the Patient-Centered Medical Home (PCMH).   While these models are becoming widely adopted, they rarely have enough resources nor the flexibility in payment structure to meet the goals laid out by the Shared Principles of Primary Care.   As shown in PCPCC’s Primary Care Innovations Map , there are exciting demonstrations, plans, and regions that are exceptions to this rule, but clinicians, on a national level, continue to struggle to realize the vision for primary care embodied in the Shared Principles.

Recent Policy and Advocacy Activity

November 5, 2018

PCPCC wrote Congress to encourage passage of the Comprehensive Care for Seniors Act of 2018 (S.3338) before the end of the 115th Congress.  PCPCC believes that Programs of All-Inclusive Care for the Elderly (PACE) exemplify many of the goals found in our Shared Principles of Primary Care – namely an emphasis on high-value care primary care that is coordinated, integrated, team-based, and incorporates patient and family caregivers.

November 5, 2018

PCPCC encouraged the Senate to act to preserve and expand access to high-value preventative care for consumers with high-deductible healthcare plans (HDHP) coupled with health savings accounts (HSAs). PCPCC is concerned that, despite increasing access to health insurance, more consumers are skipping high-value preventative primary care – most likely due to out of pocket costs associated with high deductibles.

October 16, 2018

PCPCC commented on the CMS Medicare Shared Savings Program's (MSSP) "Pathways to Success" proposed rule. PCPCC applauded changes to strengthen the program -- particularly for lower revenue, often clinician-led ACOs.   We are, however, concerned by estimates that far fewer organizations would choose to join or remain in the MSSP program. We encouraged CMS to balance its effort to incentivize ACOs to move more quickly to risk with the need to maintain a healthy pool of ACOs moving along the risk continuum.   

October 16, 2018

PCPCC joined several other groups in providing recommendations to CMS on how Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) can better address mental health, addiction, and suicide in the individuals they serve. Key recommendations included promoting behavioral health capacity in ACOs, expanding patient-reported outcomes in mental health and substance use, and offering additional outcome-based payments in behavioral health. 

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