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Continuity of care (CoC) is a central tenet of primary care and is associated with fewer hospitalizations and emergency department (ED) visits, better patterns of care utilization, lower costs for patients with chronic conditions and residents of long-term care facilities, and lower mortality.1–13 Despite this, the translation of CoC from a research construct to a clinical quality measure had been limited to a single National Quality Forum (NQF)-endorsed measure (Continuity of Primary Care for Children With Medical Complexity [NQF #3153]; endorsed in 2017), for which endorsement was removed in 2020 because the measure was withdrawn by the developer. Measures endorsed by the NQF, a not-for-profit and non-partisan organization, serve as an important foundation to improve value and safety in health care. To address the lack of clinical quality measurement of a central tenet of primary care and to promote CoC as a quality indicator for primary care physicians (PCPs), the American Board of Family Medicine developed and rigorously tested the validity and reliability of the Measuring the Value-Functions of Primary Care: Physician-Level Continuity of Care measure as a component of its Measures That Matter to Primary Care initiative. The measure received full NQF endorsement in December 2021 (NQF #3617).
As the nation struggles to find a new equilibrium in health care services delivery and financing in the wake of the COVID-19 pandemic, it faces four foundational and interconnected population health challenges: a growing recognition of the toll of health inequities on vulnerable populations, pandemic recovery and future resilience, a resurgent opioid epidemic, and a growing mental health crisis, especially for children and teens.
Investment in primary care, which the 2021 National Academies of Science, Engineering, and Medicine (NASEM) report Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care named a common good, will help the US address each of these challenges. But aligning federal levers will be necessary.