Better Health — Now: A Campaign of the Primary Care Collaborative

There’s nothing more important than our health. That’s why many of us rely on a primary care professional to partner with us and our families on the path to healthier, more fulfilling lives. 

We need strong primary care in every community, so we all have better access to health. This campaign is a way to make this vision a reality. 

As a campaign of the Primary Care Collaborative, Better Health — Now is a major vehicle the PCC is using to further its overall organizational mission:

The Primary Care Collaborative advances comprehensive primary care to improve health and health care for patients and their families by convening and uniting stakeholders around research, care delivery and payment models, and policies.

The main objective of the campaign is to secure policy change that improves the health and well-being of patients. We can do this by increasing investment in primary care and promoting primary care payment models that ensure all communities have access to care.

Missed the launch of the campaign on March 29, 2022?

Who is behind this campaign? Who supports the campaign’s objectives?

A majority of PCC’s Executive Members are participating in the campaign. Thus, participating organizations reflect the diversity of PCC’s Executive Members: primary care clinician, practices, and professional societies; professionals and allied health workers dedicated to interdisciplinary practice and collaboration; patient and consumer advocates; health equity and community advocates; healthcare purchasers; academic and research entities; quality organizations. All have real-world experience, knowledge of the evidence base, and relevant public policy expertise. We expect to welcome more PCC members to the campaign in the weeks and months ahead.

PCC member organizations become participants in the campaign when they sign on to the PCC Concordance Recommendations for Primary Care Payment + Investment

Support for payment and investment reform is strong among PCC’s Executive Members. In November 2021, the PCC gathered its members, already representing a broad range of stakeholders in primary care, and other organizations that PCC believes have a vested interest in primary care for a working summit to:

  • Provide a broad, diverse group of stakeholders the opportunity to engage with the key findings and implications of the National Academies of Sciences, Engineering, and Medicine (NASEM) report, Implementing High-Quality Primary Care
  • Connect the vision of high-quality primary care described in the report to primary care stakeholders’ own key policy objectives for the sector
  • Make the case that the NASEM report’s payment and investment recommendations are the key levers to achieve high-quality primary and gather input on recommended policies that could make those recommendations a reality
  • Expand engagement in the PCC of a targeted group of currently less-engaged stakeholders to strengthen support for the report’s payment and investment recommendations
  • Create an inclusive process that continues after the event to expand and strengthen the community of primary care leaders and stakeholders that come together at the PCC, united to advance shared priorities

Since the online working summit, a number of organizations have joined the PCC as Executive Members because they believe the PCC is the right vehicle to mount and implement this campaign, the objectives of the campaign align with their own priorities for primary care and winning the objectives of the campaign is possible.

If you are with an organization that is interested in engaging in the campaign as a Campaign Participant (PCC Executive Member) or Campaign Supporter (non-PCC member), see this page.

In addition, the PCC is grateful for the support of The Commonwealth Fund and the Samueli Foundation for their financial support.

What problem is this campaign addressing? Why do we need better health now? Is primary care currently equipped to get us to better health?

The COVID-19 pandemic hit our communities hard. To recover and thrive, families and individuals in every community need access to primary care that works for them. This campaign aims to pivot health care to community-based care that furthers better health.

 

Primary care was there for us — quickly offering telehealth, expanding its services, staffing vaccine clinics. Now we need to support primary care so it can support us in getting and staying healthier.

Deep-seated problems

COVID-19 has laid bare the deadly consequences of persistent inequities in access to care across racial, social, and economic groups, yet structural economic forces and institutional racism were ravaging communities before the virus arrived. Over recent years, those forces contributed to simultaneous epidemics of cardiometabolic disease, mental health challenges, rising substance use, violence, and despair and ultimately declines in U.S. life expectancy.

Chronically underfunded and undervalued, primary care is not well prepared and organized to help communities confront the destabilizing forces and health challenges many of them face. At the same time, primary care is singularly positioned to do the most potential good for the health of all Americans if it is rebuilt with the evidence-based tools called for in the NASEM report: paying for primary care teams that are accountable to communities.

What are the changes we want? What is the basis of our arguments for these changes?

We call on the Executive Branch and Congress to act now on the NASEM report’s first recommendation: reforming how we pay for primary care and investing more in primary care so that every community can achieve better health. We are focusing on the Executive Branch and congressional leaders because Medicare and Medicaid must lead this pivot to community-based primary care.

The bold changes identified in the report are essential to the transformation of primary care to achieve improvements in population health, expanded access for underserved communities, to advance health equity, promote overall system sustainability and affordability, improve clinician satisfaction, and grow, diversify, and improve the geographic distribution of the primary care workforce.

The NASEM report provided evidence as a basis of reforming primary care and a direction for policy changes. In the months following the NASEM report, the PCC developed Concordance Recommendations that articulate what the PCC hopes to achieve in the payment, investment and access areas of policy reforms in primary care. Using the NASEM report’s recommendations as a launching pad, the Concordance Recommendations take the NASEM recommendations a step further.

With the Concordance Recommendations, the PCC has adopted and adapted the NASEM recommendations for our campaign and to use as a set of principles to test an array of policy options that our campaign may advance. They also function as a framework for the organizations supporting the campaign and provide direction for the PCC’s education and advocacy workplan over the next two years.

The goals of the PCC Concordance Recommendations are:

1
Pivot healthcare resources to primary care.
Policymakers and healthcare leaders should re-orient our healthcare system to be more sustainable, community-focused, and equitable by investing in more robust primary care teams. Quality and length of life will improve in communities with greater investment in primary care (Concordance Recommendations 2 and 3)
2
Pay for what we want - better health.
Today, we pay piecemeal, shelling out for every test, procedure, and visit, regardless of whether we get well. We face bigger bills, but less and less time with our primary care professional. Instead, we should pay for whole-person, proactive care that keeps us healthy and prevents us from getting sick via convenient in-person and video visits as well as calls, texts and other follow-up care. This care exists today for some communities, and it works best when it’s paid for prospectively, like a monthly subscription. We urge all healthcare payers to transition primary care payment to a predominately prospective payment model to better support primary care teams' focus on better health. The prospective amount should be adjusted to support diverse expert teams, delivering an array of services, and offering convenient access and choice for all types of communities. (Concordance Recommendations 1 and 4)
3
Reduce economic and social barriers to better health.
From small towns to our biggest cities, to our own neighborhoods, many communities face growing barriers to better health, ranging from recent hard-economic times to decades of underinvestment and exclusion. Community-based primary care teams that know, reflect and are responsive to these communities and focused on improving whole-person health — both body and mind — are teams that build trust. These kind of robust primary care teams can partner and innovate with other community organizations and services to overcome economic and social barriers that get in the way of better health. (Concordance Recommendations 1, 3 and 5)

Also see a helpful summary of the PCC Concordance Recommendations (Context and Summary).

Shared Principles of Primary Care

The foundation on which the PCC’s work, including this campaign, is based is the seven Shared Principles of Primary Care. The PCC, along with FMAHealth, spearheaded the development of the principles in 2017, and to date, more than 350 organizations have expressed their support of the principles by signing on to them.

The Shared Principles are a model of the ideal way primary care should operate and be supported in the broader health system. Achieving the principles will help our country reach the goals of better health, better care, and lower costs for health care.

Therefore, the PCC believes achieving this campaign’s goals — achieving major reforms to the payment of primary care — will help primary care get much closer to the Shared Principles of Primary Care. This, in turn, will benefit patients as primary care partners with them on the path to better health.

Why this campaign? Why now?

"Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes"

—National Academies of Sciences, Engineering, and Medicine’s (NASEM) report, Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care

There are several factors in a range of areas contributing to a favorable window for major policy reforms to primary care:

  • the recognition during the pandemic of primary care’s vulnerability but also its value
  • a new commitment by many institutions, from the federal government to nonprofit organizations, to address longstanding inequities, including inequities in health
  • the commitment of Congress and the president to strengthen our healthcare system in the wake of the pandemic
  • increasing recognition of primary care’s importance to overall health by employers, health plans and primary care/private equity
  • While primary care as a sector is weaker, almost half (46%) of primary care clinicians want to move away from the majority fee-for-service payment system.
  • the National Academies of Sciences, Engineering, and Medicine’s landmark report, released in May 2021, Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care, which was received favorably and has generated new momentum for reform of various parts of primary care

All of these factors combine to underscore the importance of primary care to all people in the United States. In addition, primary care is viewed positively by both national political parties, particularly when positioned as the foundation of a high-value health system.   

The PCC is the only national multi-stakeholder organization focused on primary care. Since its founding in 2006, the PCC has built a track record of bridging divides and broadening perspectives within its big tent. With that makeup and history, the PCC wants to use its role as a convener and leader in the primary community to bring together its current members and other key healthcare and patient-oriented stakeholders to push for payment reforms in primary care with a unified voice.

For more than three years, PCC’s policy agenda has focused on changing how we pay – primary care payment reform – and how much we pay – primary care investment - to achieve the seven Shared Principles of Primary Care. The time and conditions nationally are ripe for implementing these reforms. 

What are the campaign’s strategies?

The overall strategy is to foster a more favorable environment for bold action by federal policymakers to invest in primary care payment and access while shifting toward advanced primary care payment models as described in the Concordance Recommendations. This will entail:
  • Coalition-building
    • Growing the Primary Care Collaborative membership
    • Building and sustaining new partnerships to advance the campaign
  • Policy development: Informing and shaping policy proposals that can drive transformation through alternative payment models and new investments to generate improvements in population health, address inequities, and advance equity, and ultimately slow the rate of growth in the total cost of care
  • Communication and education to policymakers: Designing, planning and implementing effective communication and education efforts aimed at policymakers that leverage the strengths and influence of our multistakeholder campaign. As appropriate and consistent with their respective missions, PCC members participating in the campaign may choose to join PCC in educating policymakers on the issues and proposals developed as part of the campaign.

How can I join the campaign?

The PCC welcomes your support and engagement. See this page for ways to engage with the campaign.

What does better health now look like? What needs to happen in primary care so we can achieve better health now?

Follow the links below to pages that provide examples of primary care moving toward the Shared Principles of Primary Care, which are the ideals of primary care that the campaign strives for.

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