HHS’ primary care initiative looks to enhance health equity

Key takeaways:

• The HHS Initiative to Strengthen Primary Health Care will focus on revamping the primary care system by integrating behavioral and environmental health, addressing patient outcomes and accessibility, and curbing ongoing public health crises.
• Increasing factors — including workforce shortages and burnout, minimal compensation compared with other specialists and financial pressures worsened by COVID-19 — have contributed to primary care’s underwhelming foundational state.

Health officials leading the HHS Initiative to Strengthen Primary Health Care plan to submit an initial action plan to HHS Secretary Xavier Becerra by the end of September.

The initiative, launched in September 2021, will address a plethora of issues that will be detrimental in revitalizing the primary care field.

At the Primary Care Transformation Summit, Judith Steinberg, MD, MPH, HSS senior adviser to the assistant secretary, said the first action plan will center around coordinated actions that HHS agencies and offices can perform that will fortify leadership and focus.

Steinberg, who is leading the initiative, cited several key benefits that help support the argument for strengthening primary health care in the United States, which include improving patient outcomes, health equity, gender-based violence, and maternal and childcare.

To strengthen primary health care, Steinberg said it will be important to support the integration of behavioral, environmental and reproductive health care so that primary care clinicians can help address issues such as the overdose epidemic and the mental health crisis among children and adolescents.

The initiative will also support efforts in combating and ending the COVID-19 pandemic, treating long COVID and helping the country prepare for the next national health emergency.

“We’ve seen how people rely on their trusted relationships with their primary care provider and team for the advice that they need to protect themselves from COVID-19, and to receive care and treatment,” Steinberg said.

The project aims to help build up a system that Steinberg referred to as being in a “weakened state,” with inaccessibility, understaffing and under-resourcing becoming frequent obstacles toward continual progression. According to the Association of American Medical Colleges, the U.S. stands to face a shortage of 17,800 to 48,000 primary care physicians by 2034.

“The new generation of providers avoid primary health care as a career choice, because of the relatively low compensation for primary care providers compared to specialists,” Steinberg said, noting educational debt dissuades potential college attendees. For those further along in their primary care careers, “work force burnout is a major issue, and many are retiring early,” she added.

Additionally, Steinberg noted the COVID-19 pandemic’s wide-ranging impact on primary care, causing practice closures and heightening financial burdens. Put all together, “primary care practices lack the infrastructure to deliver whole person, comprehensive care,” Steinberg said.

HHS’ long-term forecast projects three phases up to 2030: phase one, which will introduce strategic actions and expand current measures; phase two, which will focus on refining and scaling implementations; and phase three, which will prioritize action scaling and end with an ideal foundation for primary care.

“That is why this initial action plan needs to set up the infrastructure in HHS, so that we can develop subsequent action plans, and we can monitor the implementation and measure their impact,” Steinberg emphasized.

References:

• Request for Information (RFI): HHS Initiative To Strengthen Primary Health Care. https://www.federalregister.gov/documents/2022/06/27/2022-13632/request-for-information-rfi-hhs-initiative-to-strengthen-primary-health-care. Published June 15, 2022. Accessed Aug. 25, 2022.
• The complexities of physician supply and demand: Projections From 2019 to 2034. https://www.aamc.org/media/54681/download. Published June 2021. Accessed Aug. 24, 2022.
• Steinberg J. “The HHS Initiative to Strengthen Primary Health Care.” Presented at: Primary Care Transformation Summit; July 25-29, 2022 (virtual meeting).