Primary Care: High-Value Care for Underserved Communities Julie Wood, MD, FAAFP Senior Vice President
AAFP • 124,900 members - • Dedicated to family medicine • Family Medicine – One in five office visits – All ages, genders, diseases, and organ systems – Care: acute, chronic, and preventive – Common patient: multiple chronic conditions
Primary Care • Major PC specialties : pediatrics, internal medicine, osteopathic medicine, and family medicine • First contact, comprehensive, continuing, team-based care • “Undifferentiated patient” • Value = Triple Aim – Better health – Better care – Lower costs – 33% lower Source: Family Medicine for America’s Health
Primary Care - Poverty • U.S. most expensive, lowest performing among dev nations (Commonwealth Fund, 2014) • 82% Medicare pop have one chronic condition; 2/3 rd have multiple CC (CMS, 2012) • Low income = poor outcomes – 2011 UC Davis Study - 50% higher risk for heart disease
Primary Care Workforce • 33,000 PCP shortage by Patient-PCP Ratio Average 2035 (IOM, 2014) • 68 PCPs/100K – rural • 82 PCPs/100K – urban • Challenges : regional maldistribution, access for vulnerable populations, and aging workforce, retention, Source: Robert Graham Center, Unequal Distribution, US PC Workforce (2013) • Poverty and access
Primary Care Workforce Programs Title VII Titl VII §747 747 – Prim rimary ry Car are Tea eaching Healt lth Cen enter Graduate Med edic ical l Trai aining & & Enh Enhancement t Edu ducatio ion • gran ants fund funding Supports 740 primary care medical • residents in 27 states and DC. $39 million in FY 2016 • • THCGME funding expires with FY 2017 on $39 million in both House & September 30, 2017. Senate FY 2017 bills • Faces cuts in FY 2018 Natio ional l Hea ealt lth Ser ervic ice Cor orps • Since 1972, NHSC has offered scholarships, loan repayment to recruit and retain providers for health professional shortage areas (HPSAs). • 40,000 providers funded at $380 million/year. • Expiring at the end of FY 2017.
HPSAs
Outside the Office What are Social Determinants How does health care factor of Health? into SDOH? • Economic stability • Neighborhood/Physical environment • Education • Food • Community and social context • Health care System
AAFP: Center for Diversity and Health Equity • Workforce and diversity • Health equity research • Advocacy • Partnering and collaboration • Health equity leadership • Physician practical tools • Builds on AAFP’s work
SDOH-Health Care Initiatives • Adverse Childhood Experience (ACES) Initiatives • Primary Care-PH Integration • Health in All Policies Movement • Geospatial Analysis/Mapping • State Innovation Models Initiative (SIM)
115 th Congress Priorities • Reauthorize and Fund – National Health Service Corps – Teaching Health Center GME – Title VII – Section 747 • Support SDOH Programs – Health care, home visiting, lead poisoning prevention, opioids safety, and anti-hunger programs(Farm Bill).
Why they listen? For more in information: jw jwood@aafp.org Thank You!
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