Advocacy and Policy

2019 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 in 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: 

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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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

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 continue 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

June 25, 2019

PCPCC supports the Chronic Disease Management Act of 2019, legislation that would enable health plans to offer pre-deductible coverage of high-value services to patients that can improve outcomes and reduce complications. The legislation would create a preventive care safe harbor for treatment of chronic conditions. 

June 25, 2019

PCPCC joined other health organizations in supporting legislation that would remove cost-sharing obligations from the Chronic Care Management (CCM) code to allow more chronically ill Medicare beneficiaries to receive care coordination and case management services. The current cost-sharing requirement creates an unnecessary barrier to care. 

June 24, 2019

Included in the White House Executive Order on Healthcare Transparency was a provision directing HHS to issue guidance allowing high-deductible health plans to cover preventive care before the deductible – particularly for individuals with chronic conditions.   PCPCC has advocated for greater flexibility in pre-deductible coverage, as it would improve access to high-value primary care for the many individuals covered by high-deductible health plans. The order also included a provision potentially allowing direct primary care arrangements to be funded by Health Savings Accounts.

June 20, 2019

As part of a broad group of organizations under the Friends of NQF, PCPCC applauds Congress for the introduction of HR 3031 to continue federal funding for the National Quality Forum. The group also encourages several key changes to the bill to enhance NQF's work, namely increasing public transparency and accountability, advancing reforms to reduce administrative burden and increase alignment, and encouraging innovation in measurement to advance national health priorities.

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