Implementing High-Quality Primary Care:
Rebuilding the Foundation of Health Care

High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels.

The implementation plan will consider:

  • 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 under served 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.

To develop the implementation plan, the committee will consider successes and limitations of prior efforts to innovate in primary care, as well as the increasing demands and stresses on the primary care system, and will recommend ways to effectively scale and implement successful innovations and programs in US health care settings.

Implementing High-Quality Primary Care Graphic

An ad hoc committee, under the auspices of the National Academy of Sciences, Engineering, and Medicine, will examine the current state of primary care in the United States and develop 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.

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Sponsors

Academic Pediatric Association

Agency for Healthcare Research and Quality

Alliance for Academic Internal Medicine

American Academy of Family Physicians

American Academy of Pediatrics

American Board of Pediatrics

American College of Physicians

American Geriatrics Society

Blue Shield of California

Commonwealth Fund

Department of Veterans Affairs

FMA Health

Health Resources and Services Administration

New York State Health Foundation

Patient-Centered Outcomes Research Institute

Samueli Institute

Society for General Internal Medicine

If we increase access to robust primary care, more people and more communities will be healthier, and no other part of health care can make this claim—making primary care a common good is essential to improving health equity in this country. The pandemic was telling for the lack of focus on primary care as part of the solution and this report calls for an organizing home within the federal government so that it is not neglected again. It also calls for increased investment in primary care, training where people live and work, and IT solutions that support us in caring for people.

Robert L. Phillips, Jr., MD, MSPH

If we increase access to robust primary care, more people and more communities will be healthier, and no other part of health care can make this claim—making primary care a common good is essential to improving health equity in this country. The pandemic was telling for the lack of focus on primary care as part of the solution and this report calls for an organizing home within the federal government so that it is not neglected again. It also calls for increased investment in primary care, training where people live and work, and IT solutions that support us in caring for people.

Robert L. Phillips, Jr.
MD, MSPH

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Committee

Co-Chair
Linda A. McCauley

Co-Chair
Robert L. Phillips, Jr.

Member
Carrie Colla

Member
Christopher F. Koller

Member
Brenda Reiss-Brennan

Member
Molly Cooke

Member
Jackson Griggs

Member
Alex H. Krist

Member
Robert Weyant

Member
Hector P. Rodriguez

Member
Asaf Bitton

Member
Jennifer E. DeVoe

Member
Benjamin Olmedo

Member
Shawna Hudson

Member
Susan Fisher-Owens

Member
Luci Leykum

Member
Mary Roth McClurg

Member
Tumaini R. Coker

Member
Rebecca S. Etz

Member
Shreya Kangovi