Health Plan Innovations Transform Primary Care to Better Serve Patients

April 9, 2013

CONTACT: Rachel Schwartz
202-251-8881 (cell)
202-785-2247 (office)

WASHINGTON, D.C. — The Alliance of Community Health Plans (ACHP) has released a new report, “Strengthening Primary Care for Patients,” describing the efforts undertaken by 17 ACHP member organizations to improve the health care system by transforming primary care. The report focuses on key components of primary care redesign and the potential for improved patient care. It is the third publication in ACHP’s “Health Plan Innovations in Patient-Centered Care” series, which highlights the essential role health plans play in improving care quality, enhancing patient experience and reducing health care costs.

Patients and providers alike are often dissatisfied with the current state of primary care. Consumers are frustrated by what they feel are  unnecessary appointments that are scheduled simply to obtain a referral; appointments that feel rushed, without adequate time for relationship-building with one’s primary physician; and a perceived lack of follow-up or coordination among one’s various providers.

Additionally, the burden on primary care providers can be overwhelming, with many physicians facing schedules packed with patients, which does not leave enough time to provide each person with the necessary care. ACHP member organizations recognize the importance of well-designed primary care and have been at the forefront of work to strengthen it. By investing in primary care practice innovation, they have created a practice transformation cycle that has led to patients’ increased confidence in their ability to manage and control their own health, increased patient and provider satisfaction, shorter wait time for appointments and reduced hospital admissions and readmissions.

“Patients and their families want and deserve a health care system that coordinates their care, helps them navigate a complex system and assures that they get the care they need when they need it,” says ACHP President and CEO Patricia Smith. “The health care organizations in ACHP are redesigning the way they deliver care to fulfill this expectation.”

“…I think [care coordination] brings another level to your care,” says Sandra C., an Independent Health member who was guided through a medical emergency by a health plan care coordinator. “You know that there’s Independent Health and the doctor working together, and it really relaxes me to know I have that there. It made a big difference.”

ACHP members’ experiences in strengthening primary care provide valuable insight for health plans and provider groups seeking to improve the quality of their care and arm their patients with the information they need to take charge of their health. “Strengthening Primary Care for Patients” describes why ACHP members have been successful in transforming primary care in their communities, how to ensure sustainability of these programs and how their work can be applied to other organizations.

“After my primary care doctor ordered X-rays of my knees, instead of sending me directly to an orthopedic surgeon, I was given a DVD and booklet,” says Betty K., who has been a member of Group Health Cooperative for 35 years. “These described treatment options and helped me have a well-informed conversation with my doctor. I decided that — at 88 years-old — I would prefer to try changing my pain relief strategy to undergoing surgery and rehabilitation. So far, my choice is working.”

To highlight the release of the report, ACHP is gathering a panel of health care and delivery system transformation experts today at the Kaiser Permanente Center for Total Health from 9:00 – 10:30 a.m. (breakfast begins at 8:30 a.m.) to discuss health plan and community efforts to implement patient-centered reforms and improve the care experience for both patients and providers. Kavita Patel, M.D., managing director for Clinical Transformation and Delivery, Engelberg Center for Health Care Reform, will moderate a panel comprising Michael Cropp, M.D., president and CEO of Independent Health; Scott Smith, M.D., associate medical director of operations at Kaiser Permanente Colorado; and Marci Nielsen, chief executive officer of the Patient-Centered Primary Care Collaborative.

About ACHP

The Alliance of Community Health Plans (ACHP) is a national leadership organization bringing together innovative health plans and provider groups that are among America’s best at delivering affordable, high-quality coverage and care. The community-based and regional health plans and provider organizations from across the country that make up ACHP’s membership provide coverage and care for approximately 16 million Americans. These 22 organizations focus on improving the health of the communities they serve and are on the leading edge of innovations in affordability and the quality of care, including patient care coordination, patient-centered medical homes, accountable health care delivery and use of information technology. For more information visit