{"id":91952,"url":"https://www.kudos365.com/news/91952-a-primary-care-physician-for-every-american-science-panel-urges-by-noam-n-levey-khn","short_url":"https://www.kudos365.com/news/91952","headline":"A Primary Care Physician for Every American, Science Panel Urges || by Noam N. Levey : KHN","content":"\u003cp\u003eThe federal government must aggressively bolster primary\u003cbr\u003ecare and connect more Americans with a dedicated source of care, the National\u003cbr\u003eAcademies of Sciences, Engineering and Medicine warn in a major report that\u003cbr\u003esounds the alarm about an endangered foundation of the U.S. health system.\u003c/p\u003e\u003cp\u003eThe urgently worded report, which comes as internists,\u003cbr\u003efamily doctors and pediatricians nationwide struggle with the economic fallout\u003cbr\u003eof the coronavirus pandemic, calls for a broad recognition that primary care is\u003cbr\u003ea “common good” akin to public education.\u003c/p\u003e\u003cp\u003eThe authors recommend that all Americans select a primary\u003cbr\u003ecare provider or be assigned one, a landmark step that could reorient how care\u003cbr\u003eis delivered in the nation’s fragmented medical system.\u003c/p\u003e\u003cp\u003eAnd the report calls on major government health plans such\u003cbr\u003eas Medicare and Medicaid to shift money to primary care and away from the\u003cbr\u003emedical specialties that have long commanded the biggest fees in the U.S. system.\u003c/p\u003e\u003cp\u003e“High-quality primary care is the foundation of a robust\u003cbr\u003ehealth care system, and perhaps more importantly, it is the essential element\u003cbr\u003efor improving the health of the U.S. population,” the report concludes. “Yet,\u003cbr\u003ein large part because of chronic underinvestment, primary care in the United\u003cbr\u003eStates is slowly dying.”\u003c/p\u003e\u003cp\u003eThe report, which is advisory, does not guarantee federal\u003cbr\u003eaction. But reports from the national academies have helped support major\u003cbr\u003ehealth initiatives over the years, such as curbing tobacco use among children\u003cbr\u003eand protecting patients from medical errors.\u003c/p\u003e\u003cp\u003eStrengthening primary care has long been seen as a critical\u003cbr\u003epublic health need. And research dating back more than half a century shows\u003cbr\u003ethat robust primary care systems save money, improve people’s health and even\u003cbr\u003esave lives.\u003c/p\u003e\u003cp\u003e“We know that better access to primary care leads to more\u003cbr\u003etimely identification of problems, better management of chronic disease and\u003cbr\u003ebetter coordination of care,” said Melinda Abrams, executive vice president of\u003cbr\u003ethe Commonwealth Fund, a New York-based foundation that studies health systems\u003cbr\u003earound the world.\u003c/p\u003e\u003cp\u003eRecognizing the value of this kind of care, many nations —\u003cbr\u003efrom wealthy democracies like the United Kingdom and the Netherlands to\u003cbr\u003emiddle-income countries such as Costa Rica and Thailand — have deliberately\u003cbr\u003econstructed health systems around primary care.\u003c/p\u003e\u003cp\u003eAnd many have reaped significant rewards. Europeans with\u003cbr\u003echronic illnesses such as diabetes, high blood pressure, cancer and depression\u003cbr\u003ereported significantly better health if they lived in a country with a robust\u003cbr\u003eprimary care system, a group of researchers found.\u003c/p\u003e\u003cp\u003eFor decades, experts here have called for this country to\u003cbr\u003emake a similar commitment.\u003c/p\u003e\u003cp\u003eBut only about 5% of U.S. health care spending goes to\u003cbr\u003eprimary care, versus an average of 14% in other wealthy nations, according to\u003cbr\u003edata collected by the Organization for Economic Co-operation and Development.\u003c/p\u003e\u003cp\u003eOther research shows that primary spending has declined in\u003cbr\u003emany U.S. states in recent years.\u003c/p\u003e\u003cp\u003eThe situation grew even more dire as the pandemic forced\u003cbr\u003ethousands of primary care physicians — who didn’t receive the government\u003cbr\u003elargesse showered on major medical systems — to lay off staff members or even\u003cbr\u003eclose their doors.\u003c/p\u003e\u003cp\u003eReversing this slide will require new investment, the\u003cbr\u003eauthors of the new report conclude. But, they argue, that should yield big\u003cbr\u003edividends.\u003c/p\u003e\u003cp\u003e“If we increase the supply of primary care, more people and\u003cbr\u003emore communities will be healthier, and no other part of health care can make\u003cbr\u003ethis claim,” said Dr. Robert Phillips, a family physician who co-chaired the\u003cbr\u003ecommittee that produced the report. Phillips also directs the Center for\u003cbr\u003eProfessionalism and Value in Health Care at the American Board of Family\u003cbr\u003eMedicine.\u003c/p\u003e\u003cp\u003eThe report urges new initiatives to build more health\u003cbr\u003ecenters, especially in underserved areas that are frequently home to minority\u003cbr\u003ecommunities, and to expand primary care teams, including nurse practitioners,\u003cbr\u003epharmacists and mental health specialists.\u003c/p\u003e\u003cp\u003eAnd it advocates new efforts to shift away from paying\u003cbr\u003ephysicians for every patient visit, a system that critics have long argued\u003cbr\u003edoesn’t incentivize doctors to keep patients healthy.\u003c/p\u003e\u003cp\u003ePotentially most controversial, however, is the report’s\u003cbr\u003erecommendation that Medicare and Medicaid, as well as commercial insurers and\u003cbr\u003eemployers that provide their workers with health benefits, ask their members to\u003cbr\u003edeclare a primary care provider. Anyone who does not, the report notes, should\u003cbr\u003ebe assigned a provider.\u003c/p\u003e\u003cp\u003e“Successfully implementing high-quality primary care means\u003cbr\u003eeveryone should have access to the ‘sustained relationships’ primary care\u003cbr\u003eoffers,” the report notes.\u003c/p\u003e\u003cp\u003eThis idea of formally linking patients with a primary care\u003cbr\u003eoffice — often called empanelment — isn’t new. Kaiser Permanente, consistently\u003cbr\u003eamong the nation’s best-performing health systems, has long made primary care\u003cbr\u003ecentral. (KHN is not affiliated with Kaiser Permanente.)\u003c/p\u003e\u003cp\u003eBut the model, which was at the heart of managed-care health\u003cbr\u003eplans, suffered in the backlash against HMOs in the 1990s, when some health\u003cbr\u003eplans forced primary care providers to act as “gatekeepers” to keep patients\u003cbr\u003eaway from costlier specialty care.\u003c/p\u003e\u003cp\u003eMore recently, however, a growing number of experts and\u003cbr\u003eprimary care advocates have shown that linking patients with a primary care\u003cbr\u003eprovider need not limit access to care.\u003c/p\u003e\u003cp\u003eIndeed, a new generation of medical systems that rely on\u003cbr\u003eprimary care to look after elderly Americans on Medicare with chronic medical\u003cbr\u003econditions has demonstrated great success in keeping patients healthier and\u003cbr\u003ecosts down. These “advanced primary care” systems include ChenMed, Iora Health\u003cbr\u003eand Oak Street Health.\u003c/p\u003e\u003cp\u003e“If you don’t have empanelment, you don’t really have\u003cbr\u003econtinuity of care,” said Dr. Tom Bodenheimer, an internist who founded the\u003cbr\u003eCenter for Excellence in Primary Care at the University of California-San\u003cbr\u003eFrancisco and has called for stronger primary care systems for decades.\u003c/p\u003e\u003cp\u003eBodenheimer added: “We know that continuity of care is\u003cbr\u003elinked to everything good: better preventive care, higher patient satisfaction,\u003cbr\u003ebetter chronic care and lower costs. It is really fundamental.”\u003c/p\u003e\u003cp\u003e\u003cem\u003eSource\u003c/em\u003e: KHN (Kaiser Health News) is a national newsroom that\u003cbr\u003eproduces in-depth journalism about health issues. Together with Policy Analysis\u003cbr\u003eand Polling, KHN is one of the three major operating programs at KFF (Kaiser\u003cbr\u003eFamily Foundation). KFF is an endowed nonprofit organization providing\u003cbr\u003einformation on health issues to the nation.\u003c/p\u003e","content_plain":"The federal government must aggressively bolster primarycare and connect more Americans with a dedicated source of care, the NationalAcademies of Sciences, Engineering and Medicine warn in a major report thatsounds the alarm about an endangered foundation of the U.S. health system.The urgently worded report, which comes as internists,family doctors and pediatricians nationwide struggle with the economic falloutof the coronavirus pandemic, calls for a broad recognition that primary care isa “common good” akin to public education.The authors recommend that all Americans select a primarycare provider or be assigned one, a landmark step that could reorient how careis delivered in the nation’s fragmented medical system.And the report calls on major government health plans suchas Medicare and Medicaid to shift money to primary care and away from themedical specialties that have long commanded the biggest fees in the U.S. system.“High-quality primary care is the foundation of a robusthealth care system, and perhaps more importantly, it is the essential elementfor improving the health of the U.S. population,” the report concludes. “Yet,in large part because of chronic underinvestment, primary care in the UnitedStates is slowly dying.”The report, which is advisory, does not guarantee federalaction. But reports from the national academies have helped support majorhealth initiatives over the years, such as curbing tobacco use among childrenand protecting patients from medical errors.Strengthening primary care has long been seen as a criticalpublic health need. And research dating back more than half a century showsthat robust primary care systems save money, improve people’s health and evensave lives.“We know that better access to primary care leads to moretimely identification of problems, better management of chronic disease andbetter coordination of care,” said Melinda Abrams, executive vice president ofthe Commonwealth Fund, a New York-based foundation that studies health systemsaround the world.Recognizing the value of this kind of care, many nations —from wealthy democracies like the United Kingdom and the Netherlands tomiddle-income countries such as Costa Rica and Thailand — have deliberatelyconstructed health systems around primary care.And many have reaped significant rewards. Europeans withchronic illnesses such as diabetes, high blood pressure, cancer and depressionreported significantly better health if they lived in a country with a robustprimary care system, a group of researchers found.For decades, experts here have called for this country tomake a similar commitment.But only about 5% of U.S. health care spending goes toprimary care, versus an average of 14% in other wealthy nations, according todata collected by the Organization for Economic Co-operation and Development.Other research shows that primary spending has declined inmany U.S. states in recent years.The situation grew even more dire as the pandemic forcedthousands of primary care physicians — who didn’t receive the governmentlargesse showered on major medical systems — to lay off staff members or evenclose their doors.Reversing this slide will require new investment, theauthors of the new report conclude. But, they argue, that should yield bigdividends.“If we increase the supply of primary care, more people andmore communities will be healthier, and no other part of health care can makethis claim,” said Dr. Robert Phillips, a family physician who co-chaired thecommittee that produced the report. Phillips also directs the Center forProfessionalism and Value in Health Care at the American Board of FamilyMedicine.The report urges new initiatives to build more healthcenters, especially in underserved areas that are frequently home to minoritycommunities, and to expand primary care teams, including nurse practitioners,pharmacists and mental health specialists.And it advocates new efforts to shift away from payingphysicians for every patient visit, a system that critics have long argueddoesn’t incentivize doctors to keep patients healthy.Potentially most controversial, however, is the report’srecommendation that Medicare and Medicaid, as well as commercial insurers andemployers that provide their workers with health benefits, ask their members todeclare a primary care provider. Anyone who does not, the report notes, shouldbe assigned a provider.“Successfully implementing high-quality primary care meanseveryone should have access to the ‘sustained relationships’ primary careoffers,” the report notes.This idea of formally linking patients with a primary careoffice — often called empanelment — isn’t new. Kaiser Permanente, consistentlyamong the nation’s best-performing health systems, has long made primary carecentral. (KHN is not affiliated with Kaiser Permanente.)But the model, which was at the heart of managed-care healthplans, suffered in the backlash against HMOs in the 1990s, when some healthplans forced primary care providers to act as “gatekeepers” to keep patientsaway from costlier specialty care.More recently, however, a growing number of experts andprimary care advocates have shown that linking patients with a primary careprovider need not limit access to care.Indeed, a new generation of medical systems that rely onprimary care to look after elderly Americans on Medicare with chronic medicalconditions has demonstrated great success in keeping patients healthier andcosts down. These “advanced primary care” systems include ChenMed, Iora Healthand Oak Street Health.“If you don’t have empanelment, you don’t really havecontinuity of care,” said Dr. Tom Bodenheimer, an internist who founded theCenter for Excellence in Primary Care at the University of California-SanFrancisco and has called for stronger primary care systems for decades.Bodenheimer added: “We know that continuity of care islinked to everything good: better preventive care, higher patient satisfaction,better chronic care and lower costs. It is really fundamental.”Source: KHN (Kaiser Health News) is a national newsroom thatproduces in-depth journalism about health issues. Together with Policy Analysisand Polling, KHN is one of the three major operating programs at KFF (KaiserFamily Foundation). KFF is an endowed nonprofit organization providinginformation on health issues to the nation.","published_at":"2021-05-05T11:17:13-07:00","updated_at":"2022-06-02T15:12:21-07:00","author":{"type":"Person","name":"Newsbytes","url":"https://www.kudos365.com/profiles/297890-newsbytes"},"description":"Stay up-to-date with Newsbytes on Kudos365. View their photo published May/05/2021 on Public Interest. Browse your favorite topics and share your expertise, too.","type":"photo","image":"https://k365pi.imgix.net/b964c055-9527-47fd-8305-9b4d372f869e-healthcare---doctor-4303020_1920.jpg?auto=compress,format\u0026fit=max\u0026w=1200\u0026h=1200\u0026q=48","likes_count":9,"comments_count":1,"categories":[{"name":"Public Interest","url":"https://www.kudos365.com/categories/1070-public-interest"}],"schema":{"@context":"https://schema.org","@type":"CreativeWork","url":"https://www.kudos365.com/news/91952-a-primary-care-physician-for-every-american-science-panel-urges-by-noam-n-levey-khn","headline":"A Primary Care Physician for Every American, Science Panel Urges || by Noam N. Levey : KHN","image":"https://k365pi.imgix.net/b964c055-9527-47fd-8305-9b4d372f869e-healthcare---doctor-4303020_1920.jpg?auto=compress,format\u0026fit=max\u0026w=1200\u0026h=1200\u0026q=48","author":{"@type":"Person","name":"Newsbytes","url":"https://www.kudos365.com/profiles/297890-newsbytes"},"datePublished":"2021-05-05T11:17:13-07:00","interactionStatistic":[{"@type":"InteractionCounter","interactionType":"https://schema.org/LikeAction","userInteractionCount":9}],"subjectOf":[{"@type":"Thing","name":"Public Interest","url":"https://www.kudos365.com/categories/1070-public-interest"}]}}