National Academy of Sciences

Provisions in the Affordable Care Act were intended to support preventive primary care, and the Centers for Medicare & Medicaid Services and the Agency for Healthcare Research and Quality have devoted more than 1 billion dollars to research and demonstration projects largely aimed at transforming primary care.

However, it is unclear if or how these efforts will be sustained or expanded upon if they demonstrate benefit to primary care practice. Although significant focus has been placed on improving access to and delivery of high-quality, comprehensive primary health care, progress has been too slow. In 2019, NYHealth awarded the National Academy of Sciences (NAS) a grant in support of a consensus study that will recommend ways to effectively scale and implement innovations in primary care.

Under this grant, a committee was formed and charged with building on the recommendations of the 1996 Institute of Medicine report, “Primary Care: America’s Health in a New Era.” Committee members’ areas of expertise included primary care delivery; clinician training and education; implementation science; health care administration; health disparities; health care technology; federal, state, and local health care and public health programs and policies; and health care finance. The committee held workshops and other information-gathering activities, as well as analyzed current scientific evidence on a range of topics, including the expanding scope of primary care; changes in training and workforce; care delivery and payment models; and behavioral and social determinants of health. The committee used findings and conclusions to produce a final report on actionable recommendations for addressing the barriers to implementing high-quality primary care.