Seven Primary Care Organizations Call for Changes to Care Model

With primary care providers severely strained by COVID-19, seven primary care physician organizations have released recommendations to change the way care is delivered and financed.

The seven organizations are the American Academy of Family Physicians, the American Academy of Pediatrics, the American Board of Family Medicine, the American Board of Internal Medicine, the American Board of Pediatrics, the American College of Physicians, and the Society of General Internal Medicine. Together they represent more than 400,000 physicians.

Convened by the Larry A. Green Center at Virginia Commonwealth University and X4 Health, these seven national organizations have developed recommendations to advance primary care as a public good, shift the model of financing primary care and dismantle the regulatory and financing structures that interfere with optimal individual and population health. The unified vision includes a shift from cost-based attributes of the current model (sick care, organized around episodic, transactional, and fragmented care delivery) to a model grounded in health equity and investment – with attributes based in health and organized around longitudinal, relational and integrated care delivery.

"Primary care physicians cannot adequately meet the needs of their communities if they remain shackled to payment schemes which reimburse for volume instead of value," said John Brady, M.D., chair of the American Board of Family Medicine, in a statement. "Many current regulatory demands unnecessarily distract clinicians from patient care. Coming out of the pandemic, a return to the status quo is not sufficient. The American public deserves better."

In an open letter to policymakers, payers, purchasers and the public, the seven organizations call on: 

• The federal government to increase investment in safety net programs, public health agencies and community-based services and support so that they may partner with the medical care sector in addressing structural racism and social drivers of health.

• Healthcare organizations to invest in existing community-based social services and ensure that the flow of dollars supports services such as food banks and other safety net programs that address social drivers of health.

• Fellow physician and clinician societies to create a roadmap for dismantling the policies and regulatory structures that enshrine the current paradigm, and to build multi-stakeholder support for a roadmap.