In an article for The Hill, John Rother discussed the need for several key healthcare policy reforms advocated by the National Coalition on Health Care. His recommendations highlight ways to improve on care delivery and provider payment models.
“To build an American health-care system that delivers better care at a lower cost, primary care must become a national health policy priority.” — John Rother, President and CEO of the National Coalition on Health Care
These issues are more relevant today than ever before as we navigate through the current COVID-19 outbreak and prepare for future pandemics. Central to his argument for reform is an increased focus on primary care. Here’s why.
America is behind
“Successful employers, plans, and health systems are finding strong primary care to be absolutely essential,” writes Rother. But as a country, we don’t seem to be getting the message.
About 4 to 8 percent of healthcare spending in the United States goes to primary care, compared to an average of 12 percent in other industrialized countries whose overall healthcare spending is also less.
With current primary care spending at minimal levels, payers have a significant opportunity. Those who decide to integrate primary care into their plans today will gain a first movers advantage over their competitors and solidify their relevance in their market.
Value-based primary care drives better health outcomes
A primary care investment works best if it is implemented with a value-based financial model. This type of primary care helps people become healthier. It’s that simple, but it takes time and an initial investment to work.
“Moving toward population- based payments and financial risk provides a strong incentive for clinicians to resource front end, primary and holistic care that has been shown to successfully offset unnecessary hospital readmissions, emergency room visits and other preventable health-care costs,” says Rother.
Traditional fee-for-service payment plans restrict providers from being able to provide the types of services that could help their patients the most. More flexible plans combined with a stronger investment in primary care would allow providers to offer a broader range of services for chronically ill patients, including behavioral care like health coaching.
Vera leading the voice of reform
Rother’s recommendations echo the direction of Vera’s advanced primary care model. By focusing on primary care, we’re helping people become healthier. By avoiding fee-for-service payment plans, providers can provide patients with the treatment they need. By improving access and reducing cost barriers to primary care, we’re ensuring that our patients and our clients reap the benefits.