Primary Care Investment and Payment Reform to Achieve Equity

An ad hoc committee, under the auspices of the National Academy of Sciences, Engineering, and Medicine, examined the current state of primary care in the United States and developed an implementation plan to build upon the recommendations from the 1996 IOM report, "Primary Care: America's Health in a New Era", to strengthen primary care services in the United States, especially for underserved populations, and to inform primary care systems around the world.

The new report, Implementing High-Quality Primary Care Rebuilding the Foundation of Health Care, published on May 4, considers:

• Barriers to and enablers of innovation and change to achieve high-quality, high-value primary care;
• The expanding scope of comprehensive primary care integration to address the needs of individuals, families, and communities;
• The role of primary care in achieving population health outcomes and health equity goals;
• The role of team-based interprofessional practice and the range of primary care providers, including those with oral health, lifestyle, and integrative medicine expertise;
• The evolving role of technological and other innovations in delivering patient-centered primary care;
• Education and training needs for the changing workforce in primary care;
• The evolution and sustainability of care delivery and payment models across different communities and care settings;
• Efficient approaches to meaningful measurement and continuous improvement of care quality;
• Changing demographics and the primary care needs and access of different patient populations, including rural and other underserved populations;
• Identifying and addressing behavioral and social determinants of health and delivering community-oriented, whole person care; and
• The infrastructure (workforce, data, and metrics) needed to evaluate effectiveness of innovation and its impact on health outcomes and to support data-informed decision-making.