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Covid-19 shows primary care's value to diverse communities and how to pay for it []


By Christina Severin, MedCityNews, September 13, 2020

If Covid-19 has a silver lining for healthcare, it is the light it shines on the value of primary care. On the front lines of pandemic testing and management, primary care serves the majority of patients, enabling emergency departments and hospitals to treat the acutely ill.  But primary care – and the relationships that form its foundation – is equally important in treating the everyday epidemic of chronic conditions we face in the U.S. today, especially in diverse communities.

There, primary care builds trust, reaches people in the languages they speak and how they speak them, and serves their physical and behavioral health. Since the 1970s, Federally Qualified Health Centers (FQHCs) have emerged as trusted coordinators of primary care in low-income communities, addressing health disparities common among people of color and the pressing social issues that cause them.

Addressing the full range of physical, behavioral, and social needs in complex, low-income populations requires an enhanced primary-care model featuring an expanded, multidisciplinary team that includes community health workers addressing social determinants of health, and peer supports and recovery coaches working with people with mental health and substance use disorders.  It demands flexibility for community health workers, nurses, and even providers to spend time with patients outside of the health center, virtually and in-person. These innovations don’t work under the fee-for-service (FFS) payment model, which incentivizes providers to generate volume, rather than prioritize the comprehensive teamwork that is needed to provide patients with optimal care.

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