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
Learn More

Primary Care Investment Workshop

Slides and Recap of PCPCC's Nov 9, 2018 Workshop on Primary Care Investment

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

September 24, 2018

PCPCC submitted comments to the Centers for Medicare and Medicaid Services (CMS) supporting changes in the Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems that seek to align payment rates across settings, so that patients can choose the setting that best meets their needs. PCPCC wrote that the transition to alternative payments that reward value requires a site-neutral payment system that does not incentivize a specific setting.

September 12, 2018

PCPCC members convened for a workgroup on the integration of behavioral health and primary care. Members identified a wide range of opportunities for PCPCC including opportunities to improve existing behavioral health payment codes, empowering patients and clinicians, and influencing alternative payment programs.

September 10, 2018

PCPCC submitted comments to the CMS on the Physician Fee Schedule and Quality Payment Program. PCPCC emphasized the importance of maintaining forward momentum on value-based and alternative payment models, reducing unnecessary documentation burdens, using technology to support approaches like eConsults, promoting interoperability credits for PMCHs, and allowing risk under Medicare Advantage plans to count for MIPS credit.

August 29, 2018

Governor Carney of Delaware has signed significant primary care legislation into law . 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.  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.

PCPCC Public Statement:

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