I was fortunate to be among a group of 40 to 50 people who recently spent a day grappling with how we in New York State can more quickly implement new models of primary care that could change the way patients in New York experience health care. As more people gain health insurance coverage, and as the health care system looks to save money and emphasize keeping people healthy (not just treating them once they're sick), primary care is becoming more important than ever.
The meeting was sponsored by three New York organizations that play key roles in shaping our State's health system: the United Hospital Fund, the Primary Care Development Corporation and the New York chapter of the American College of Physicians. They invited physicians and other leaders of large and small organizations that provide primary care, health insurance payers (including insurers and employers) and State government officials to share ideas about how an energized primary care system could create a better day-to-day health care experience for patients and eventually lower health care costs.
One thing that made the meeting productive (and hopeful!) was a shared sense of goals for our State among these diverse players. Consensus surely supported the need for a larger role (and more resources) for primary care and payment reform that makes health care both more responsive to patients' needs and more affordable. And just last week, the New York State Department of Health released a draft plan for supporting advanced primary care in New York State. The plan sets out to do much of what we discussed at the meeting: achieving the "triple aim" of improved health, better health care quality and consumer experience and lower costs.
Four main themes stood out:
- We only spend about 5 percent of health care expenditures on primary care today. The overwhelming share of health care dollars go to hospitals that work to repair people who do not get the type of primary care that can solve health problems early and avoid high-cost health care. What if we increased spending on primary care by, say, 40 percent? That would only raise health care costs by 2 percentage points. Taking a long view, we know that investing in good primary care will save much more than 2 percent of the high-cost services like hospital care and emergency room care. Rebalancing our health care spending to support more primary care is better for both our health and our wallets.
A key first step to meet the challenge of systems change is understanding how we can make the investments that are required and learn the new approaches to care that are necessary but still do our "day jobs" of caring for people day in and day out. Other American industries have successfully transformed themselves on the go; we in health care need to learn from those successes.