Strengthening Primary Care

Strengthening Primary Care is the third report in ACHP’s Health Plan Innovations in Patient-Centered Care series. Health plans can be invaluable partners to practices that aim to transform their delivery of primary care as well as improve health outcomes, patient and provider satisfaction and financial viability. The case studies in this report demonstrate how plans provided infrastructure grants to support investments in health information technology and new staff; convened practice collaboratives to spread innovations and best practices; engaged consultants to facilitate provider-led change; and developed new payment and reimbursement models that rewarded comprehensive care. The report, a two-page summary of main points and outcomes and longer profiles on each organization can be found below.

Long Profiles on Individual Organizations:

Capital Health Plan : Strengthening Primary Care Profile

CareOregon: Strengthening Primary Care Profile

Capital District Physicians’ Health Plan: Strengthening Primary Care Profile

Colorado Permanente Medical Group: ACHP Strengthening Primary Care Profile

Geisinger Health Plan: ACHP Strengthening Primary Care Profile

Group Health Cooperative of South Central Wisconsin:  Strengthening Primary Care Profile

Group Health Cooperative: Strengthening Primary Care Profile

HealthPartners: Strengthening Primary Care Profile

Hawaii Permanente Medical Group: ACHP Strengthening Primary Care Profile

Independent Health: ACHP Strengthening Primary Care Profile

Martin’s Point Health Care: ACHP Strengthening Primary Care Profile

Presbyterian Health Plan: Strengthening Primary Care Profile

Priority Health: Strengthening Primary Care Profile

Rocky Mountain Health Plans: Strengthening Primary Care Profile.docx

Southern California Permanente Medical Group: ACHP Strengthening Primary Care Profile

UCare: Strengthening Primary Care Profile

UPMC Health Plan: Strengthening Primary Care Profile

The issue:

  • Weaknesses and inefficiencies in the current primary care system frequently leave consumers dissatisfied with their care, often leading people to bypass primary care altogether.

Our findings:

  • ACHP member organizations understand that strengthening primary care in the context of a “medical neighborhood,” in which care is coordinated across providers and health agencies, improves patient satisfaction and health outcomes, reduces health disparities across a population and lowers costs.
  • Health plans can be invaluable partners to physician practices aiming to transform their delivery of primary care by providing funds to support investments in health information technology and new staff; convening practice collaboratives to spread innovations and best practices; and developing new payment and reimbursement models that reward comprehensive care.
  • Due to their close relationships with providers and knowledge of local health systems, ACHP members are uniquely positioned to pull together the resources of numerous organizations into an improved system that strengthens care for the people within the community they serve.

Outcomes:

  • All 17 ACHP member organizations profiled increased quality care, improved patient and/or provider experience and/or lowered costs. Many did all three, demonstrating that health plans and provider groups do not have to sacrifice quality and patient experience for cost.

Bottom line:

  • Health plans play a vital role in the success of primary care transformation.
  • Focusing on coordination and continuity of care, and rewarding quality and efficiency, benefits consumers and the entire health care system.
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