Advanced Primary Care
The Problem We’re Solving For:
Employers know that primary care is essential to a healthy workforce and employees’ access to a high-value health care system. Studies show that robust systems of primary care can lower overall health care utilization, disease and death rates and increase the use of preventive services. Strong primary care also may reduce the negative effects of income inequality and is associated with more effective and equitable health services.
Despite the enormous benefits, a host of existing market dynamics continue to severely constrain primary care’s potential, including misaligned financial incentives, infrastructure barriers and a lack of integration with other elements of care — including behavioral health.
That’s why PBGH has developed a set of advanced primary care attributes used by payers, providers and health care purchasers to incentivize high-quality, lower-cost primary care with patients at the center of every interaction. We are working to scale high-quality primary care through the development of a national network that is vetted to include a region’s highest performing primary and specialty care practices.
PBGH’s approach to advanced primary care redirects existing health care spend to high-quality, equitable and evidence-based care while holding total cost flat.
What We’re Working Toward:
PBGH and its members are working toward a model of ‘advanced primary care’ that:
- Redirects current health care spending to primary care and changes the way primary care is paid for, moving away from a fee-for-service system and toward flexible and prospective population-based payment.
- Uses rigorous outcomes and quality metrics to identify high-performing providers and drive patients to those providers.
- Enables comprehensive care that includes screenings and management of behavioral and social needs.
- Makes available clinical and claims data needed to enable coordinated care between primary care teams and other care providers, including a referral network to high-performing specialists.
- Uses tools and systems to address social determinants of health that support population-based care and the provision of care management for patients with chronic conditions.
How We’ll Get There:
PBGH is building on its years of groundbreaking work to define and promote advanced primary care to improve health, well-being, prevention and early intervention. Our approach builds on our years of experience as an operating partner for the Employers’ Center of Excellence Network (ECEN) and takes it to its next evolution.
By developing a turnkey national primary center of excellence network with quality-based specialty referrals – a network built to reflect purchaser priorities – we believe we can make significant strides in both health improvement and total cost management.
Initiatives
A History of Pioneering Advanced Primary Care
Read More about A History of Pioneering Advanced Primary CarePBGH has been a pioneer in defining and promoting the adoption of advanced primary care.
California Advanced Primary Care Initiative
Read More about California Advanced Primary Care InitiativeThe California Advanced Primary Care Initiative is an effort to strengthen the primary care delivery system throughout the state.
Advanced Primary Care Resources
Read More about Advanced Primary Care ResourcesThrough successive initiatives and in collaboration with a diverse group of committed stakeholders, PBGH has spearheaded efforts to create a blueprint for optimized primary care.
Featured
8 Steps to Implementing Advanced Primary Care
Despite these outsized benefits, misaligned financial incentives, chronic under-investment, infrastructure barriers and a lack of integration with other elements of care continue to severely constrain primary care’s impact on the health of American workers and families.
Strengthening Primary Care: A Pilot with Four Large Purchasers
Together with the Integrated Healthcare Association (IHA), PBGH brought together four large health care purchasers in California to pilot this set of performance measures that emphasize patient experience and outcomes.
Employers Are Driving Innovations in Primary Care
Large employers are increasingly working with existing direct contracting partners and new vendors to enhance primary care, which includes, among other things, the integration of behavioral health care.
A Little Less Conversation, A Little More Action
Large employers and health care purchasers have increasingly begun to take actionable steps to strengthen primary care, the critical precursor to a high-quality, cost-effective health care system.
Using Primary Care’s Potential to Improve Health Outcomes
Through successive initiatives and in collaboration with a diverse group of committed stakeholders, PBGH has spearheaded efforts to create a blueprint for “advanced primary care.”
Quality Improvement Project to Modernize Primary Care Launched
Covered California, the California Public Employees’ Retirement System (CalPERS) and the Purchaser Business Group on Health (PBGH) are partnering to launch a pilot program to promote improvement in primary care which will benefit all Californians.
Resources
Advanced Primary Care Request for Information
The Journey to Advanced Primary Care
Advanced Primary Care Measurement Pilot
Advanced Primary Care Measure Set
PCC Shared Principles of Primary Care
Advanced Primary Care: Defining a Shared Standard
Advanced Primary Care: Defining a Shared Standard Technical Brief
Announcements
Quality Improvement Project to Modernize Primary Care Launched
Covered California, the California Public Employees’ Retirement System (CalPERS) and the Purchaser Business Group on Health (PBGH) are partnering to launch a pilot program to promote improvement in primary care which will benefit all Californians.
Past Events and Training
CQC Webinar – Advanced Primary Care: Piloting Practice Level Measurement
A webinar describing the next step in California’s journey to scale high quality, efficient and patient-centered primary care, also known as Advanced Primary Care (APC).
CQC Webinar: Increase Depression Screening
In this meeting, attendees shared challenges and questions related to depression screening at their organizations, and identified a next step they could apply at their own organizations.