5.7 Primary Care and Public Health

The committee recommends that health care plans and public health agencies develop specific written agreements regarding their respective roles and relationships in (a) maintaining and improving the health of the communities they serve and (b) ensuring coordination of preventive services and health promotion activities related to primary care.

5.8 Primary Care and Mental Health Services

The committee recommends the reduction of financial and organizational disincentives for the expanded role of primary care in the provision of mental health services. It further recommends the development and evaluation of collaborative care models that integrate primary care and mental health services more effectively. These models should involve both primary care clinicians and mental health professionals.

5.9 Primary Care and Long-Term Care

To improve the continuity and effectiveness of services for those requiring long-term care, the committee recommends that third-party payers (including Medicare and Medicaid), health care organizations, and health professionals promote the integration of primary care and long-term care by coordinating or pooling financing and removing regulatory or other barriers to such coordination.

5.10 Quality of Primary Care

The committee recommends the development and adoption of uniform methods and measures to monitor the performance of health care systems and individual clinicians in delivering primary care as defined in this report. Performance measures should include cost, quality, access, and patient and clinician satisfaction. The results should be made available to public and private purchasers of care, provider organizations, clinicians, and the general public.

5.11 Primary Care in Academic Health Centers

The committee recommends that academic health centers explicitly accept primary care as one of their core missions and provide leadership in the development of primary care teaching, research, and service delivery programs.

Chapter 6

6.1 Programs Regarding the Primary Care Workforce

The committee recommends (a) that the current level of effort to increase the supply of primary care clinicians be continued and (b) that these primary care training programs and delivery systems focus their efforts on improving the competency of primary care clinicians and on increasing access for populations not now receiving adequate primary care.

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