PCC Winter 2021 newsletter

 
 

In This Issue

Click on a link below to be taken to that article.

Message from the President & CEO
Happy Holidays from the PCC
PCC Will Work to Advance Payment Reform During 2022
Policy & Advocacy Update
Executive Member Spotlight
Primary Care Champion: Michael Thompson
PCC Presents its Top Achievements of the Year
New Report on Integrating Primary Care and Public Health: Lessons from COVID-19
Attend the Next PCC Lunch and Learn Discussion on Primary Care Research
Health Care Value Week in January
PCC Webinars
New Articles, Research & Resources
Upcoming Conferences, Webinars & Events
Consider PCC Membership in 2022
 

Message from
Ann Greiner,
President & CEO





Dear Colleagues,

Last week, the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health released a new report - Integrating Primary Care and Public Health to Save Lives and Improve Practice During Public Health Crises: Lessons from COVID-19. The report found that the failure to bring primary care clinicians into a frontline role as responders to the COVID-19 pandemic, alongside the public health system, resulted in many missed opportunities to provide better quality care, faster testing, more effective contact tracing, greater acceptance of vaccination, and better communication with patients. (Full disclosure: I was a reviewer of the report.)
 
This report looked at the same sectors that we examined in PCC’s 2021 Evidence Report - Primary Care and COVID-19: It’s Complicated—Leveraging Primary Care, Public Health, and Social Assets – primary care, public health and community-based organizations, against the backdrop of COVID. While the perspective of the Johns Hopkins report is slightly different than the PCC report, the main message of the Hopkins report resonates with PCC’s report bottom-line message: Primary care’s valuable assets must play a bigger role in our country’s pandemic response.
 
As we enter 2022, we will soon pass the pandemic’s two-year mark. Omicron notwithstanding, we all want the pandemic to be over. PCC’s 2021 evidence report message remains incredibly relevant as we work to move beyond this challenging scourge: Primary care is key to getting us to the other side.
 
As we embark upon a new year, PCC is ramping up a new initiative, a message of transformation of primary care through payment reform and investment. A more robust primary care that can successfully confront pandemic challenges, population health challenges, equity challenges, mental health issues and so much more. Read about the exciting work we have planned for the next few years below.
 
In the meantime, I hope you find some time to rest during the holiday season. This year, like 2020, has had its share of challenges. But we all need time to recharge and come back to our work refreshed and ready to make positive changes in primary care in the new year. As inspiration for the work before us, I’d like to share the short video that opened our online working summit last month.
Opening video from PCC's online working summit, Nov. 2021
Wishing you and your family a restful, safe and happy holiday season and a happy new year,

 

Happy Holidays from the PCC

The staff of the Primary Care Collaborative wish you and yours happy, safe and healthy holidays. It has been a pleasure engaging with you this year and sharing in the work of making primary care better, more robust and more responsive to patients' needs and preferences. We look forward to continued work with you in 2022.

 

PCC Will Work to Advance Payment Reform During 2022

The PCC convened an online working summit - From Crisis to Opportunity: Primary Care for All Communities - Nov. 9 and 10. The event brought together PCC Executive Members along with other groups that the PCC believes have a stake in strengthening primary care - community health workers, rural health voices, FQHCs, CHCs, health equity advocates, primary care innovators and those working in behavioral health and oral health.
 
The goal of our summit was to build on the momentum generated by the 2021 National Academies of Sciences, Engineering, and Medicine (NASEM) report, Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care, and begin to build a coalition to advance the report’s payment recommendations.
 
See PCC’s media release about the summit.
 
PCC’s work in 2022

 
Moving NASEM’s payment recommendations forward will take a team effort. The PCC is drafting a strategic action plan to advance bold primary care payment reform over the next two years. We will engage our community to study design features of primary care population-based payment models. Open discussion and transparency can build greater trust and support for change and help to align payers.
 
More specifically, with Commonwealth Fund support, Robert Berenson, MD and Mai Pham, MD will lend expertise to our payment reform discussions, along with other policy advisors. We will assess the evidence from Center for Medicare and Medicaid Innovation payment models, hear directly from early adopters, and urge commercial payers and practices to share results and learnings from their efforts.    
 
Lastly, we will disseminate shared learnings to inform policymakers, community and business leaders, and advocates as they rebuild healthcare delivery and public health infrastructure in states and communities. We will lift up collaborations producing better, more equitable outcomes in states such as Oregon and Rhode Island. We will bring the voices of leaders at the forefront of transformation together with communities that have the most to gain from a stronger primary care system and demonstrate the power of partnerships to further health and equity.
 
We hope you will be among those voices. Stay tuned for ways you can be involved in this vital initiative in 2022!
 

Primary Care Investment in States

 
When state legislatures gavel in their 2022 sessions, legislation measuring or increasing overall primary care investment could be on the docket in at least four important states: California, Maine, Massachusetts and New York.
 
PCC continues to lift up state progress and highlight what is possible when states and stakeholders work together.
  • PCC’s quarterly State Primary Care Investment Workgroup meeting in December included a presentation from Maine State Rep. Sam Zager, MD (D-Portland) on his work championing investment legislation in the state.
  • PCC Policy Adviser Ann Kempski delivered a presentation on PCC’s 2021 Evidence Report findings to the AAFP State Legislative Conference.
  • State officials and advocates from Oregon, Massachusetts, Rhode Island and Maryland participated in the PCC’s 2021 working summit in November. 
Moving forward, PCC plans to monitor progress and support this critical state-level work. 
 
To find where your state stands on primary care spending, check out PCC’s 2020 Evidence Report, which examined primary care spending between 2017 and 2019 and in all 50 states (and nationally) for the commercially insured.
 
To learn how other state leaders have succeeded with legislation, read PCC’s December 2020 brief: Lessons from Multi-Stakeholder Advisory Groups
 
If your organization is ready to engage in these conversations, contact PCC’s Director of Policy, Larry McNeely, at [email protected] to get connected to PCC’s State Primary Care Investment Workgroup.
 

Administration Update

 
Can the New CMS Innovation Strategy Support Primary Care for All Communities?
 
The new CMS Innovation Center strategic direction, outlined in its recent white paper, Driving Health System Transformation: A Strategy for the CMS Innovation Center’s Second Decade, offers real opportunities to strengthen primary care – but only if the community acts upon those opportunities.
 
There is a great deal to like about the white paper from the perspective of primary care. Primary care is woven throughout CMS’s strategic vision. The paper explicitly lifts up the NASEM report, Implementing High-Quality Primary Care. Advancing health equity is the second stated strategic objective, and the paper gives a particular focus on extending and adapting alternative payment models to communities of color, rural places and smaller practices. There is a clear emphasis on patient engagement.
 
But much hinges on how current and future leaders interpret and implement CMS’s first strategic objective: All Medicare beneficiaries and the vast majority of Medicaid beneficiaries will have a relationship with a clinician who is accountable for total cost of care and quality. Meeting this commitment will require changes to underlying Medicare and Medicaid payment policy - not just a few small pilots. If embraced across administrations and Congresses, this ambitious goal creates an opportunity for primary care to advance bold reforms and investments in primary care. Nonetheless, it will be critical that the emphasis on total cost of care not lead to unnecessary shifts of risk to small and independent primary care practices, particularly those serving communities facing entrenched health inequities.
 
In recent weeks, PCC highlighted the white paper’s constructive elements while emphasizing the need to strengthen primary care, including:

Congressional Updates


Build Back Better Act’s Future in Doubt: The House-passed Build Back Better Act, with its major health coverage provisions and primary care investments, now faces an extremely uncertain future.  The U.S. Senate adjourned for the year without bringing up the bill. On Dec. 19, Sen. Joe Manchin (D-W.V.), whose support will be necessary for any bill, announced his opposition on “Fox News Sunday.”

Senate Finance Committee Staff Join PCC Policy Meeting: PCC’s Nov. 16 policy meeting featured a dialogue with the Majority and Minority staff for the Senate Finance Committee responsible for Medicare Part B, telehealth and planned bipartisan mental health package, Peter Fise and Conor Sheehey.

Committee staff are working through stakeholder responses to a recent request for information and aspire to produce bipartisan mental health legislation in 2022. There is also interest in a bipartisan approach to telehealth. If the calendar permits, Chairman Ron Wyden (D-Oregon) is also interested in beginning a conversation on Chronic Care 2.0, a sequel to that committee’s bipartisan CHRONIC Care Act of 2018.

A Win on Broadband Infrastructure: On Sept. 15, $65 billion in funding for broadband internet infrastructure and access, focused on rural and underserved areas, was signed into law as part of the H.R. 3684 Infrastructure Investment and Jobs Act (IIJA).  

PCC endorsed the BRIDGE Act, the basis for the IIJA’s enacted broadband provisions, in 2020. Closing the digital divide was also an important plank in PCC’s Primary Care Priorities document, submitted to the incoming Biden administration in December 2020. 

PCC Backs Primary and Virtual Care Affordability Act: On Oct. 17, PCC endorsed the bipartisan Primary and Virtual Care Affordability Act (H.R. 5541) in a letter to its cosponsors, Reps. Bradley Schneider (D-Illinois) and Brad Wenstrup (R-Ohio).   
 
According to the 2021 Kaiser Family Foundation Employer Health Benefits Survey of private and non-federal employers, approximately 28% depended on a high-deductible health plan with a savings option such as a health savings account (HSA/HDHPs), but these plans bar coverage for many primary care services until patients meet their deductible. 

High deductibles present barriers to needed primary care, and a temporary, pandemic-related provision that offers relief from deductibles for telehealth services expires Dec. 31, 2021. 

HR 5541 would extend the telehealth waiver to Dec. 31, 2023, while simultaneously allowing employers and health plan sponsors the flexibility to waive cost-sharing for in-person primary care as well. 

PCC Joins Effort to Sustain Small, Underserved Practice Assistance: On Nov. 19, PCC joined the National Partnership for Women and Families, American College of Physicians, American Academy of Family Physicians and other stakeholders to support renewed funding for practice improvement among small practices that serve Medicare beneficiaries in rural locations, health professional shortage areas, and medically underserved areas. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established the Quality Payment Program-Small Underserved and Rural Support (QPP-SURS) program to provide direct assistance to eligible clinicians required to participate in the Merit-based Incentive Payment System (MIPS).

AHRQ Primary Care Research Appropriations: Report language accompanying the House-passed FY 2022 Labor HHS Appropriations bill included $5 million for the Center for Primary Care Research at the Agency for Health Research and Quality (AHRQ). The Senate Appropriations Committee has not marked up Labor HHS legislation. However, report language released by committee Democrats expresses support for the Center for Primary Care Research but does not specifically allocate $5 million to the center.

The ultimate outcome depends first on bipartisan agreement to pursue full-year FY 2022 appropriations and then House/Senate negotiations and passage of Labor HHS appropriations bill. A Continuing Resolution extending FY 2021 funding expires Feb. 18, 2022.

In late April 2021, PCC issued a letter to House and Senate leadership requesting this dedicated funding for the center, first authorized in 1999 but never expressly funded by Congress.
 
This is a regular feature of PCC’s monthly enewsletter. We focus on a different Executive Member of PCC every month and spotlight some of the current campaigns, initiatives or work in primary care that they’re implementing.
 
Would you like to appear here? Would your organization/company like to be featured in a future issue of this newsletter? Do you have exciting, interesting or useful work to talk about or resources that other members may find useful? Be in touch with us.


The Alzheimer’s Association has been a PCC Executive Member since September 2017. The organization works to end Alzheimer’s and all other dementia by accelerating global research, driving risk reduction and early detection, and maximizing high-quality care and support. The association is the leading voluntary health organization in Alzheimer’s care, support and research. Its vision: A world without Alzheimer’s and all other dementia.®
 
The association shares PCC’s commitment to ensure primary care and the broader healthcare system is well-positioned to ensure high-quality care for all Americans.
 
The organization’s headquarters is in Chicago, and it has chapters across the country.
 
As the leading advocate and champion for more than 6 million Americans living with Alzheimer’s, their caregivers and families, the association is focused on wide-ranging health policy and dementia care initiatives aimed at advancing new and better treatments for Alzheimer’s, while providing quality care and support to all those affected.
 
The Alzheimer’s Association is uniquely positioned to provide proven strategies and resources to support primary care clinicians as they manage an increasing number of patients with dementia. The association partners with primary care clinicians and practices to increase equitable access to timely detection, accurate diagnosis, and quality, person-centered care. In 2018, the Association launched Project ECHO, a highly successful telementoring program, that has connected more than 50 primary care practices with dementia care experts to enhance dementia care in underserved areas.
 
The association is also partnering directly with over 300 health systems in the U.S., from community health centers to large, integrated delivery networks, and offers guidance and resources for them at alz.org/professionals/health-systems-clinicians
 
The Alzheimer’s Association also plays a leading role in making Alzheimer’s and other dementia a national priority, advocating for public policies that established a national framework for addressing the disease, increasing critical research funding and support for all those affected. 
 
Currently, the association is working with bipartisan congressional champions to streamline today’s complicated health care maze for people living with dementia and their caregivers. The bipartisan Comprehensive Care for Alzheimer's Act (S. 1125 / H.R. 2517) would ask the Center for Medicare and Medicaid Innovation (CMMI) to test a different payment structure for dementia care management.
 
Accompanying these robust efforts to support primary care, while creating a national framework to tackle Alzheimer’s disease, the Alzheimer’s Association is also engaged in accelerating global disease research aimed at advancing new and better treatments. The association is the largest private, nonprofit funder of Alzheimer’s disease and dementia research with current research investments totaling more than $250 million—providing funding for 750 projects in 39 countries.
 
The association looks forward to its ongoing work with PCC and its stakeholders to further empower and position primary care as an instrumental ally in the fight to end Alzheimer’s and all other dementia.

I Am a Primary Care Champion

This is a regular feature of PCC’s newsletter. Each issue features a short profile of an individual who works in primary care. It is a way of recognizing the dedication and passion that clinicians, advocates, and others have for primary care and connecting readers of this newsletter to people like them.

Michael Thompson


President and CEO
National Alliance of Healthcare Purchaser Coalitions


Why are you passionate about primary care?
 
Health care is often too focused on reacting to just the issues at hand. Primary care is our opportunity to focus on working with people to improve their health over time. By building a strong longitudinal and trusting relationship with the patient, these efforts can lead to lasting changes that benefit patients. When done effectively, these efforts can also mitigate the healthcare needs and costs beyond primary care – key to increased value for both patients and purchasers. This is why we recommend employers and other plan sponsors invest more strategically in what we have defined as advanced primary care.
 
The savings can be significant – a Portland State University study found that every $1 increase in primary care resulted in a $13 savings in specialty care, emergency department, inpatient care, and other healthcare services. Most importantly, the impact to health is significant as adults with primary care doctors have almost 20% lower risk of premature death than for those who only see specialists.
 
If you had a magic wand that you could wave to change one thing in primary care, what would it be?
 
There are many who have said we must invest more in primary care, but we must be strategic about how we invest with an eye toward the key factors that provide value not just to patients but across the healthcare system. A strategic focus will enable us to better support people with increased health needs and, particularly, to treat the whole person, rather than just the presenting condition.
 
What one thing about your work do you want people working outside primary care to know or understand?
 
For the majority of Americans, employers and other plan sponsors are the ultimate payers of health care and the biggest advocates for employees and their families. For healthcare strategies to be successful and sustainable, they should meet the needs of both the patients and the purchasers who finance the care. We believe that the principles of advanced primary care are both patient-centered and a strong investment for those paying the bills. The National Alliance recently worked with the Purchaser Business Group on Health and the PCC to align a related set of advanced primary care attributes to the Shared Principles of Primary Care. The PCC convened consumer organizations to offer further input on these attributes, with AARP, the Institute for Patient and Family Centered Care and the National Partnership for Women and Families ultimately endorsing these practice attributes. 
 
Looking back on your career, what’s the most significant contribution to primary care that you or your team have made?
 
The pandemic has exacerbated the shortcomings of our healthcare system but also opened promising opportunities to make meaningful course corrections. Primary care has much to contribute to drive a more adaptable, streamlined, efficient system focused more on prevention and value. The National Alliance has made a concerted effort to change the conversation to better define the elements of advanced primary care that are critical to adding value within the health system – both for patients and for purchasers.

From our perspective, key attributes of advanced primary care include enhanced access for and time with patients, integration of behavioral health, a disciplined focus on improvements in health risk factors and an intentional approach to managing high-performing referrals. These strategies must also be enabled by realigned payment and critical organizational infrastructure. In partnership with regional coalitions, physicians, employers, consultants, health plans, and other experts, we’ve developed tools and resources, including a recently released playbook, to equip plan sponsors seeking to promote high-value primary care for their families.
 
We know that if we invest wisely, this investment will pay for itself many times over.
 

PCC Presents its Top Achievements of the Year

It’s been quite a year – full of challenges, for sure, but also full of opportunities. Throughout 2021, the PCC seized these opportunities and worked to advance a better, stronger and more equitable primary care system.

See our Top Ten Accomplishments of 2021 for our major areas of work and biggest achievements. The best part of this year has been doing these things with you and with your engagement – leaders and champions of primary care.
 

 New Report: ‘Integrating Primary Care and Public Health to Save Lives and Improve Practice During Public Health Crises: Lessons from COVID-19’

The Johns Hopkins Center for Health Security at the Bloomberg School of Public Health released a new report Dec. 14 finding that the failure to bring primary care clinicians into a front-line role as responders to the COVID-19 pandemic, alongside the public health system, resulted in many missed opportunities to provide better quality care, faster testing, more effective contact tracing, greater acceptance of vaccination, and better communication with patients.

The new report, Integrating Primary Care and Public Health to Save Lives and Improve Practice During Public Health Crises: Lessons from COVID-19, also identified other unrealized benefits that could have helped, had there been better integration of primary care, public health, and community-based organizations:
  1. Greater support for the public health response, thereby easing the burden on overstretched public health personnel
  2. Ability to access primary care’s reach to amplify public health messaging
The authors conclude that action is needed to address the barriers that exist between primary care and public health and to correct misalignment across systems. A new transformative vision is needed where public health is central to the delivery of health care in the U.S. and where local primary care, public health and community networks are strengthened and expanded.
 
Ann Greiner, PCC’s President and CEO, was one of the reviewers of the report.

PCC’s 2021 Evidence Report Also Examines Role, Coordination of Primary Care, Public Health, and Community-Based Organizations During COVID

 
Primary Care and COVID-19: It’s Complicated—Leveraging Primary Care, Public Health, and Social Assets, the PCC’s annual evidence-based report for 2021, found that in communities with the most robust primary care, the strongest public health infrastructure, and the fewest social vulnerabilities, residents were 42% less likely to die from COVID-19 and 12% less likely to get infected with the virus, as compared to communities on the other end of the spectrum. Data at the U.S. county level - from both before and after the COVID-19 vaccines were made widely available - were analyzed for the report.
 
The report, released Oct. 18, was produced in collaboration with the Robert Graham Center.
 
Visit the web page for the report, where you’ll find:
  • Full report (PDF)
  • Executive summary (PDF)
  • PCC’s news release about the report
 

Attend the Jan. 27 PCC Lunch and Learn Discussion on Primary Care Research

Discussion Series is Part of Project to Translate Research and Evidence into Action

 
Lunch and Learn discussions bring together primary care researchers, advocates, policymakers and others to discuss key findings and policy implications of important research, with the goal of better integrating the research findings into their organizational and policy decisions.
 
Meetings are open to all PCC members and non-members who are interested in engaging in conversation with academic researchers, policymakers, advocates, and executives about translating primary care’s research and evidence base into action.
NEXT DISCUSSION:
Jan. 27, 2022
11:00 a.m.-12 p.m. ET
Registration details will be shared in January
These articles will be discussed: Want a taste of the discussions?
 
At the previous Lunch and Learn discussion on Dec. 7, participants heard Mark Ebell, MD, professor at the University of Georgia, College of Public Health; Frank Moriarty, PhD, senior lecturer in pharmacy and biomolecular sciences at the Royal College of Physicians in Ireland; and Karen Swietek, MPH, PhD, senior health economist at NORC, discuss their papers, Do Medical Homes Improve Quality of Care for Persons with Multiple Chronic Conditions? and A comparison of contemporary versus older studies of aspirin for primary prevention.
 
Watch a recording of the December discussion and read more highlights of the meeting.
 
About the overall project
 
The discussion series is part of PCC’s Bridging the Gap in Primary Care Research project. With the support of the Research Dissemination Workgroup (RDWG), part of the same project, the PCC is producing a curated list of approximately 25 seminal primary care clinical and health-services research articles. As a means of sharing relevant health services and clinical research more widely, the PCC is convening the Lunch and Learn discussions quarterly and creating a resource “hub” on its website.
 
For more information about the overall project or Lunch and Learn, contact Noah Westfall.
 

PCC to Host 'Health Care Value Week' in January with Other Leading Health Care Stakeholders

Value-based healthcare models have been at the core of healthcare improvement efforts for decades. By improving quality of care, reducing costs, and eliminating a range of health disparities, new payment and delivery system transformation models continue to demonstrate their power to address the most intractable healthcare challenges across public and private healthcare programs.

To celebrate the progress made to date and chart a path forward on key legislative and regulatory priorities, a diverse group of leading health industry stakeholders are hosting Health Care Value Week, beginning Jan 24, 2022.

Health Care Value Week will feature opportunities for interested stakeholders to participate in meaningful dialogue with healthcare executives and policymakers in the administration and Congress through virtual events and social media. The opening event will be held Jan. 24, 2022, and will be a special edition of the Virtual Value-Based Payments Summit: Update on CMS/CMMI Payment Reform Initiatives, featuring remarks from top administration officials at the Centers for Medicare & Medicaid Services (CMS) Innovation Center. See more information, including a link for free registration.

The initial list of organizations sponsoring Health Care Value Week includes Aledade, Alliance of Community Health Plans, American Academy of Family Physicians, The Alliance for Technology Driven Health, America’s Physician Groups, Caravan Health, Cityblock Health, Evolent Health, Global Health Care LLC, Health Care Transformation Task Force, McDermott+ Consulting, Medical Group Management Association, National Association of ACOs, Partnership to Empower Physician-Led Care, Premier, Inc., Primary Care Collaborative, Primary Care for America, Signify Health, Sirona Strategies and the Value Based Care Coalition.

Visit the website for information about how to become a Health Care Value Week sponsor as well as a schedule of events and other resources including a list of media contacts for specific events.

 

PCC Webinars

Most Recent PCC Webinars

 

Technology and Advanced Primary Care


December 16, 2021
Technology is a key driver on the road to the future. But technology can bring primary care to some favorable and some unfavorable places. What is working to uphold the promise of advanced primary care captured in the Shared Principles of Primary Care? How might technology be undermining such promise? How is technology enhancing the quadruple aim, and where may it be getting in the way? How does equity factor in? How could better use of technology have helped primary care and public health during the pandemic? This webinar explores these questions and more with experts and thinkers on healthcare tech and information. 

Panelists:
  • Charles DeShazer, MD, Director, Clinical Products, Google
  • Anil Jain, MD, FACP, Chief Innovation Officer, Innovaccer
  • Elisa Choi, MD, FACP, FIDSA, internal medicine physician/HIV medicine/infectious diseases, Somerville, Mass.
Moderator: Sarah Hajjar, Director of the PRIME Registry, The Center for Professionalism & Value in Health Care
 

Primary Care: A Team Sport?


September 30, 2021
Ask any sports coach about working with a team, and they will tell you there are many considerations, including which skill sets to assemble and how to manage and motivate a group of people toward a common goal. Team-based care is one of the Shared Principles of Primary Care, PCC’s vision for advanced primary care, which more than 350 organizations have embraced, and a necessary feature to achieve comprehensiveness and equity, among other principles. In a practice setting, leaders need to assess how a team meets patients’ needs and consider related logistical, infrastructure and payment frameworks. Who are the players on a primary care team, from physicians, nurses and other clinicians to behavioral health specialists, pharmacists and care coordinators? How can team members play well together and provide high-quality, comprehensive and equitable care for their patients? Who leads the team, and does leadership shift depending upon the context? What is the latest evidence about what contributes to team effectiveness? This webinar explored these questions and more with a diverse panel of experts on team-based care.

Panelists:
  • Andrew Diamond, MD, PhD, medical staff member, One Medical San Francisco
  • Anthony Makarich, PharmD, VP, Clinical Services, Catalyst Health Network
  • Christine Arenson, MD, Co-Director, National Center for Interprofessional Practice and Education and Professor, Family Medicine and Community Health, University of Minnesota

Moderator: Katherine Hempstead, PhD, Senior Policy Adviser, Robert Wood Johnson Foundation

 

New Articles, Research & Resources

Research: Building Quality Improvement Capacity in Smaller Primary Care Practices

Implementing seven evidence-based strategies to build quality improvement capacity in smaller primary care practices was associated with improved blood pressure control, according to an Agency for Healthcare Research and Quality-funded study published in Annals of Family Medicine. The study examined 209 practices in Washington, Oregon and Idaho participating in the AHRQ EvidenceNOW Healthy Hearts Northwest initiative that implemented evidence-based strategies, including:
  • Embedding clinical evidence into daily work to guide delivery of care
  • Utilizing data to improve clinical performance measures
  • Establishing regular quality improvement processes among cross-functional teams
  • Identifying at-risk patients through proactive outreach
Quality improvement (QI) capacity was assessed over a 15-month period, and researchers found statistically significant improvement in QI capacity between baseline and follow-up, especially for establishing regular QI processes. Researchers did not find a strong association between the QI capacity and clinical quality measures on appropriate aspirin use and tobacco cessation counseling.
 

Research: Trends in Outpatient Care for Medicare Beneficiaries and Implications for Primary Care, 2000 to 2019

Michael L. Barnett, MD, MS; Asaf Bitton, MD, MPH; Jeff Souza, MA; Bruce E. Landon, MD, MBA, MSc in Annals of Internal Medicine
 
The proportion of Medicare beneficiaries with any PCP visit annually only slightly increased from 61.2% in 2000 to 65.7% in 2019. The mean annual number of primary care office visits per beneficiary also changed little from 2000 to 2019 (2.99 to 3.00), although the mean number of PCPs seen increased from 0.89 to 1.21 (36.0% increase). In contrast, the mean annual number of visits to specialists increased 20% from 4.05 to 4.87, whereas the mean number of unique specialists seen increased 34.2% from 1.63 to 2.18. The proportion of beneficiaries seeing 5 or more physicians annually increased from 17.5% to 30.1%. In 2000, a PCP's Medicare patient panel saw a median of 52 other physicians (interquartile range, 23 to 87), increasing to 95 (interquartile range, 40 to 164) in 2019.
 

Resource: New curriculum on integrating behavioral health into primary care

The California Quality Collaborative, a program of the Purchaser Business Group on Health (a PCC Executive Member), has developed an online resource guiding teams through 20 months of work across 7 project phases to start or improve behavioral health (BH) integration into primary care. Primary care organizations can use the curriculum to complete self-directed virtual learning activities and access curated resources from more than 40 expert organizations to launch or expand BH screening, treatment and referrals for patients with mild- to moderate-severity depression, substance use disorders and other conditions. The curriculum was created with the support of the California Health Care Foundation.
 

Article: “Integrating oral health into primary care”

In the November/December 2021 issue of ACP Internist
“Medicine and dentistry have traditionally been separate domains, with distinct insurance structures and payment models…Despite previous calls for integration—including two separate reports issued in 2011 by the Institute of Medicine and the Interprofessional Education Collaborative Practice—there remains little overlap between the silos of medical and dental care.”
 

Article: The Critical Role of Health Information Technology in the Safe Integration of Behavioral Health and Primary Care to Improve Patient Care

Mark Segal PhD, FHIMSS; Patricia Giuffrida MSN, RN, CPHIMS ECRI; Lorraine Possanza DPM, JD, MBE, FACFOAM, FAPWCA, ECRI; David Bucciferro BS, Certification in Psychiatric Rehabilitation
 
Published in October in The Journal of Behavioral Health Services & Research
 
Technology can enable integration of behavioral health and primary care and improve delivery of care. The Partnership for Health IT Patient Safety and the HIMSS Electronic Health Record Association (EHRA) formed a workgroup to examine using information technology to facilitate integration. Taking a three-pronged approach focused on: 1) screening for behavioral health issues; 2) clinician documentation; 3) sharing data among clinicians, patients, and authorized parties the workgroup developed action-oriented recommendations and strategies for safe use of health IT for stakeholders and policymakers seeking to advance efforts to integrate behavioral health with primary care.
 

Upcoming Conferences, Webinars & Events

PCC's Online Event Calendar
Events are listed on PCC's event calendar on its website. Updated regularly, the calendar lists events of interest to the primary care community.
 

Become a PCC Executive Member in 2022!

Planning in your organization for next year? Put membership in the PCC on your list!

Executive Membership in PCC comes with many benefits.
Becoming an Executive Member allows you to:
  • Connect and network with organizations and individuals from different stakeholder groups who share a common commitment to furthering primary care
  • Contribute to the PCC’s policy and advocacy work 
  • Receive the monthly member-only e-newsletter that highlights policy developments, upcoming events, and key issues related to primary care 
  • Join and become an active participant in PCC's workgroups
  • Receive discounts on event registrations 
  • Sponsor events and initiatives   
  • Do much more 
Visit the Executive Member page for more information, and watch the short (less than 2 minutes) video below that features organizations and why they chose to become Executive Members.
 
If you have questions about the membership process or benefits or would like to schedule a conversation about joining the PCC, please contact: 
 
Maria Sulima
Membership Coordinator
[email protected]
 
Get more information and apply for membership
 

Follow PCC on Facebook and Twitter

Are you active on social media?

Follow PCC on Facebook and Twitter. PCC provides regular announcements and updates on:
  • upcoming PCC webinars
  • events of interest to the primary care community, such as Twitter chats
  • policy and advocacy issues
  • news and developments in primary care
 
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