How We Can Provide Better Primary Health Care

Source: Pexel

As appalling as the COVID-19 pandemic was, it brings into play what healthcare executives and practitioners already knew: Our system has a glaring weakness in basic care.

A new in-depth report from the National Academies of Sciences, Engineering, and Medicine (NASEM) offers a crucial roadmap for how, from this moment on, we can learn to create and finance a system of care that will make us a healthier nation for generations to come .

COVID-19 has dramatized our long-standing weaknesses: Our health system is designed to treat diseases, but not to prevent them. For example, patient visits to the family doctor account for 35 percent of medical care, but only make up 5 percent of expenditure. On the flip side, only 3 percent of medical care comes as inpatient hospital visits, but they make up a whopping 26 percent of spending.

We got the equation wrong. We pay five times as much to address issues that could potentially be mitigated if we focus on high quality primary care, which NASEM now defines as integrated, accessible and equitable care sustained by a team over time, that affects the whole patient – his or her health and well-being, not just the resulting pain.

While the financial strain from our current resource misalignment has been evident for some time, COVID-19 has caused a body count of nearly 600,000 people in the United States. It focused on those with chronic but preventable diseases, such as obesity, diabetes, and high blood pressure, at increased risk.

How can we improve health care?

We have to stop this downward spiral. NASEM’s report, released last month, outlines a blueprint for reshaping the structure, philosophy, and funding of primary care. Advanced primary care and solid public health investments are proven solutions to these problems. The change described in this report offers great hope and promise – if our political leaders, my colleagues and the public can embrace its scientifically based, sensible recipe for change.

I have been practicing and researching primary care for 40 years and have seen firsthand how care can be advanced to create health and wellbeing. This happens when patients are treated as a whole person and have more access to a team of providers – not just doctors.

An approach like this offers interdisciplinary medical teams of doctors, nurses, health trainers, behavioral and mental health specialists, nutritionists, and others trained to educate, empower, and support patients to develop and maintain healthy habits that will prevent disease . first of all. Patients are more proactive and committed to their own health rather than asking their doctors about the latest drug they saw on TV.

The system integrates all forms of medicine including proven non-pharmacological treatments such as yoga, meditation, acupuncture and various mind-body practices with the best of evidence-based pills and procedures, eliminating ineffective treatments that are so often pushed for commercial reasons.

This is not an idea from Heaven. In fact, it is already used in regional health systems and by the Veterans Health Administration, which introduced an integrative “whole health” model with interdisciplinary teams in 2018. The VA pilot study followed 130,000 veterans for two years and found that it improved results. with a 20 percent cost reduction, or $ 4,500 per veteran, while improving health outcomes and the nursing experience.

Incentives to promote health

The models of health promotion exist, but how can we make them universal? America can do this, mostly through new models of care and financial incentives to spread them. It is time to change funding models so that they offer opportunities for a new type of care, rather than sticking us into old-fashioned models. In fact, the National Academies of Medicine are picking up on this topic in another series of workshops that focus on changing healthcare payment systems to focus on health and wellbeing this month.

From here, the Biden government’s health and welfare officials must lead the way by incentivizing advanced primary care, particularly in federal health clinics that treat 30 million underserved Americans. Medicare and Medicaid systems need to accelerate the deployment of monetary drivers that have been shown to improve prevention. States and private insurers need to be encouraged to take steps that have been proven to prevent disease, save money, and measure what is essential.

Roadblocks are in the way. With current models of care, many systems have benefited from the rise in healthcare costs. With the right financial incentives, we can change that. As we take our next steps forward, we need to embrace truly transformative change. We don’t have to pay for health care, but for health and wellbeing.

Note: The Samueli Foundation was proud to be a sponsor of the study. Other sponsors were: the American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics, the Agency for Healthcare Research and Quality, the US Department of Veterans Affairs, and others.

source https://dailyhealthynews.ca/how-we-can-provide-better-primary-health-care/