Publications

The National Academies of Sciences, Engineering, and Medicine report, Implementing High-Quality Primary Care,¹ correctly identified that the Biden Administration’s priority goals for heath equity and a more effective and affordable health system require a sustained initiative to strengthen the nation’s fragile primary care infrastructure. In this Viewpoint, we reconsider the promise of the Primary Care Extension Program to strengthen and ensure access to high-quality primary care. The Patient Protection and Affordable Care Act (ACA)² originally directed the Agency of Healthcare Research and Quality (AHRQ) to establish the program; however, Congress did not appropriate funds to make it operational.

There is increasing pressure on frontline clinicians, particularly those in primary care, to assess patients for social needs — for instance, poverty, housing instability, food insecurity, and unemployment — which can be potent drivers of health outcomes. While identifying these needs is important, without resources to address them directly or the ability to partner with community-based organizations, clinicians are left powerless. Being pushed to assess without resources can be a source of frustration and burnout for clinicians who are motivated to help their patients.