As providers prepare for potential upheaval in healthcare regulations, they are reaching out to legislators to remind them about a key, but often-forgotten element of the U.S. healthcare system: primary care.
The National Coalition on Health Care hosted a forum on Capitol Hill Wednesday that showcased how new payment models have allowed primary care to better coordinate patient needs and focus on a team-based approach. The panel noted that, despite the role primary care plays in reducing healthcare costs, it makes up just a fraction of what is spent on healthcare in the U.S.
Michael L. Munger, M.D., president-elect of the American Academy of Family Physicians, said that because of this trend, it’s no surprise that the U.S. spends more on healthcare than any other industrialized country, but has poorer outcomes than many of its peers.
Investment in primary care is necessary, he said, because it focuses on a whole-person approach. Patients also develop relationships with their primary care providers that they may not have with hospitalists, specialists or other providers, Munger said.
“You’re going to see those themes over and over again,” he said. “That’s what’s special about primary care.”
The four panelists—Munger; Alan Del Castillo, D.O., a family medicine doctor with Lakeside Community Healthcare in California; Benjamin Miller, a psychologist and director of the Eugene S. Farley Health Policy at the University of Colorado-Denver; and Nitin S. Damle, M.D., president of the American College of Physicians—highlighted three payment models in which primary care has been able to improve patient outcomes:
- Patient-Centered Medical Homes: Focuses on care coordination and a team-based approach
- Collaborative Care Model: Team-based care that incorporates mental health treatment into the primary care setting
- Independence at Home: A home-based primary care model that is particularly beneficial to patients with multiple chronic illnesses
Miller stressed the importance of incorporating mental healthcare into primary care, saying that keeping those two elements of whole-person care siloed means that “patients must work harder for care.” He noted that a significant number of people who committed suicide saw a primary care physician within 30 days of their deaths.
“We artificially separate the mind from the body,” Miller said.
Damle called on legislators to continue the Center for Medicare and Medicaid Innovation, as it drives payment reforms under the transition to value-based care. He also addressed GOP-led efforts to repeal the Affordable Care Act, noting that the number of uninsured Americans is at its lowest level, and it’s extremely expensive to treat patients without insurance.
“We really see the effects of the ACA on a daily basis in our practice,” Damle said.