Main Library
Primary care practices provide most mental health services that patients receive, in place of, or in collaboration with, mental health specialists. They are also the most common source of preventive services, care coordination, and partnership with other sectors outside health care, such as social services, that are necessary to achieve health equity. The US grossly underfunds primary care and restricts payment to a narrow set of services not reflective of what patients need and not in accord with how high-performing primary care practices work.
We propose a dramatic redesign of Medicare payment for current and new primary care functions and increased payment levels. We can no longer afford to wait for pilot programs to generate change at scale. A decade of experimentation with medical home and value-based payment models points the way to permanent solutions, captured in recent recommendations from the National Academes of Science, Engineering, and Medicine.