July Lunch and Learn Discussion

A forum for researchers and policymakers to translate primary care evidence into action

PCC Journal Club July 22, 2021

Lunch and Learn (Formerly Journal Club) Meeting Highlights
Thursday, July 22, 2021
1:00 PM – 2:00 PM ET

The Journal Club hosted two primary care researchers, Dr. Sanjay Basu, Director of Research at the Harvard Center for Primary Care, and Dr. Eugene Rich, Senior Fellow at Mathematica, who presented their papers, Association of Primary Care Physician Supply With Population Mortality in the United States, 2005-2015 and Primary Care Practices Providing a Broader Range of Services Have Lower Medicare Expenditures and Emergency Department Utilization.

Dr. Irene Dankwa-Mullan and Dr. Jack Westfall facilitated the group’s questions and a discussion about policy implications which focused on the importance of paying primary care differently, strengthening the primary care physician workforce, and expanding the range of services delivered by primary care practices to better meet patients’ essential physical and common mental health needs.

Summary of Discussion Highlights:

  • Finance whole-person care:
    • Do not pay only for utilization but pay for wraparound services through a chronic-care model.
    • Pay for outcomes on a risk-adjusted basis where the risk calculator is invisible to the clinician.
  • Strengthen the medical education pipeline:
    • Medical schools are graduating fewer primary care clinicians.
    • Identify medical education, residency and post-residency incentives that improve the rate of primary care specialization among students.
  • Expand team-based care:
    • Utilize the full range of the primary care workforce including mobile pharmacists, mobile health workers, social workers, and so on, allowing each profession to work at the top of their license.
    • Conduct more research on the range of services provided in practices that include NPs and PAs.
  • Integrate behavioral health and primary care:
    • When practices provide a broader range of services (including counseling), their Medicare beneficiaries subsequently experience fewer ED visits and lower total spending.
    • Include team members who have behavioral health skills and take advantage of existing primary care physician competencies.
      • E.g., family medicine has historically included training in basic mental health counseling and cognitive behavioral therapy.
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