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

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 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

July 11 – House Ways and Means Committee passage of the “Provide High Deductible Health Plans with First Dollar Coverage Flexibility Act (HR 6301).  The Legislation would give health plans more flexibility to provide high-value, low-cost services under a high-deductible health plan while maintaining health savings account eligibility by allowing plan spending of up to $250 for an individual or $500 for a family prior to reaching the deductible. The bill is intended to allow insurance plans to offer coverage for services like telehealth; low cost chronic disease management; or primary care visits.

June – PCPCC engaged with Delaware policymakers in advance of the Delaware House passage of Senate Bill 227 including a presentation at a Delaware Primary Care Roundtable. Governor Carney is expected to sign the legislation soon. This legislation promotes the use of primary care by:

  1. Creating a Primary Care Reform Collaborative under the Health Care Commission. The collaborative will issue written recommendations on or before January 8, 2019 regarding appropriate levels of system-wide primary care investment, including an evaluation of whether 12% of health care spending should be directed to primary care and how primary care supports a cost spending benchmark. 
  2. Requiring payers to participate in the Delaware Health Care Claims Database.
  3. Requiring payers to reimburse primary care physicians, certified nurse practitioners, physician assistants, and other front-line practitioners for chronic care management and primary care at no less than the physician Medicare rate for the next three years.

May 25 - PCPCC provided comments to CMS on the Direct Provider Contracting Models Request for Information.  PCPCC emphasized several themes:

  • CMS must further develop its thinking in this area, focusing this effort on unique opportunities to affect change, then create another opportunity for more detailed feedback and guidance.
  • Strong beneficiary protections, dependent on how the model is structured, will be needed – including strong risk adjustment and quality measurement, which needs further investment.  
  • While PCPCC supports new efforts to engage more providers in value-based care, CMS should avoid changes that might undermine existing programs that are already creating change due to limitations in CMMI’s staff and funding capacity. 
  • Direct contracting in primary care should be an opportunity to increase funding for, and capability of, primary care to address health needs both within and outside of the practice.
  • Cost containment should not be the primary emphasis of a new model, as it will lead to the wrong priorities when designing and launching a model.  Improving quality though a stronger patient-clinician relationship must be the goal.  

May 17 - PCPCC wrote Congressional appropriators to express concern over proposed funding reduction to CMMI through the rescission process. 

May 11- PCPCC Joined More than 500 Organizations to Oppose CHIP Funding Reduction

March 13 - PCPCC officially became a member of the Smarter Health Care Coalition, which works to integrating benefit design innovations and consumer/patient engagement within broader delivery system reform in order to better align coverage, quality, and value-based payment goals.

March 12 - PCPCC joined other Leading Health Organizations on a Letter Urging Rapid Action to Stabilize Health Insurance Markets.

February 22 - PCPCC held a nationwide webinar on “Overcoming Challenges to Ideal Primary Care.”  Several policy issues were discussed, including efforts to strengthen the rural healthcare workforce, simplify electronic health records, and finding resources to support advanced primary care.

January 30 - PCPCC held a nationwide webinar highlighting Oregon’s Support for Strong Primary Care through the Oregon Health Authority Patient-Centered Primary Care Home Program and through a recent law doubling investment in primary care.

January 29 - PCPCC and other leading health organizations wrote Congressional Leaders to urge continued funding for key programs aimed at health care services for seniors on Medicare and patients in underserved communities, resources for health care providers in rural communities, and programs aimed at training primary care physicians.


December 20 - PCPCC joined other leading health organization in urging Congress to fund health care programs critical to millions of low-income, working Americans and others who face financial challenges.

November 22 - PCPCC Called on CMS to Maintain Leadership on Value-Based Payment in its comments on the future of the Center for Medicare and Medicaid Innovation.

November 9 - PCPCC President and CEO Ann Greiner spoke about delivery system reform and the importance of strong, coordinated primary care at an Alliance for Health Policy event, Care Delivery in the Future: The Role of the Health Care Workforce

October 25 - PCPCC spoke at the Engaging Consumers, Providers, and Payers for the Future of Value-Based Insurance Design Summit in Washington, DC. President and CEO Ann Greiner spoke about the importance of actively engaging consumers through strong primary care when engaging in value-based designs.

October 24the Patient-Centered Primary Care Collaborative and ABIM Foundation’s Choosing Wisely Announced a Partnership to foster meaningful partnerships between clinicians and patients, families, and community-based organizations to reduce opioids, unnecessary antibiotics, and low-value imaging as well as other services that are not necessary, redundant or even harmful. 

September 22 - PCPCC issued a statement on the Graham-Cassidy Health Care Bill highlighting several provisions that are problematic for advancing strong primary care.

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