Health Extension in New Mexico: An Academic Health Center and the Social Determinants of Disease

Kaufman, Arthur; Powell, Wayne; Alfero, Charles; Pacheco, Mario; Silverblatt, Helene; Anastasoff, Juliana; Ronquillo, Francisco; Lucero, Ken; Corriveau, Erin; VanLeit, Betsy; Alverson, Dale C.; Scott, Amy

doi:10.1370/afm.1077

Cited by 45 publications

(41 citation statements)

References 13 publications

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“…Summit participants examined roadmaps for transforming primary care practices with team-based approaches. Examples highlighted included the 10 Building Blocks of High-Performing Primary Care, 29 team strategies for integrating behavioral health and primary care, 30 incorporating patients and communi-ties into primary care teams (eg, community health workers), 31 and approaches for increasing joy in practice. 32 Participants concluded that effective teams must be adaptable with regard to the needs of the population, size of the community, and specific roles of team members.…”

Section: ) Team-based Care: Revisiting and Revitalizing Old Modelsmentioning

confidence: 99%

"A Paradox Persists When the Paradigm Is Wrong": Pisacano Scholars' Reflections from the Inaugural Starfield Summit

Doohan

Coutinho

Lochner

et al. 2016

The Journal of the American Board of Family Medicine

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Section: ) Team-based Care: Revisiting and Revitalizing Old Modelsmentioning

confidence: 99%

"A Paradox Persists When the Paradigm Is Wrong": Pisacano Scholars' Reflections from the Inaugural Starfield Summit

Doohan

Coutinho

Lochner

et al. 2016

The Journal of the American Board of Family Medicine

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“…[14][15][16][17][18] Another PCEP prototype that has placed particular emphasis on a population health framework is the Health Extension Rural Offi ce (HERO) program coordinated by the University of New Mexico. 19 The HERO program partners with communities in every county of the state, identifying community health needs and mobilizing academic health center resources to meet those needs. HERO has trained and deployed community health workers to areas of need in support of primary care practices.…”

Section: Evidencementioning

confidence: 99%

The Primary Care Extension Program: A Catalyst for Change

Phillips¹,

Kaufman

Mold

et al. 2013

The Annals of Family Medicine

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The Affordable Care Act authorized, but did not fund, the Primary Care Extension Program (PCEP). Much like the Cooperative Extension Program of the US Department of Agriculture sped the modernization of farming a century ago, the PCEP could speed the transformation of primary care. It could also help achieve other goals such as integrating primary care with public health and translating research into practice. The urgency of these goals and their importance to achieving the Triple Aim for health care should increase interest in rapidly building the PCEP, much as the need to feed the country did a century ago. 2013;11:173-178. doi:10.1370/afm.1495. Ann Fam Med INTRODUCTIONP assage of the Affordable Care Act of 2010 (ACA) laid a foundation for unprecedented support of primary care, placing it at the core of a learning health care system that seeks to achieve the Center for Medicare and Medicaid Services' Triple Aim: improving the experience of care, improving the health of populations, and reducing per capita costs of health care.1 This article seeks to help clinical and policy leaders understand how critical the Primary Care Extension Program (PCEP) is to enhancing primary care effectiveness, to the integration of primary care and public health, and to translating research into practice, all with the goal of achieving the Triple Aim for health care. 2,3 Before the ACA, primary care leaders were already engaged in designing and testing new models of care, particularly the patient-centered medical home (PCMH). Evidence suggesting that these reformed models of primary care improve health outcomes while reducing costs has stimulated a surge of interest for widespread transformation of primary care. 4,5 Many of these high-performing models have increased capacity for monitoring and managing population health, and some have bridged the substantial gap between primary care and public health. 6,7 Despite early evidence and growing enthusiasm, primary care transformation has not yet arrived at a tipping point, and the United States lacks a mechanism for facilitating the change. PRIMARY CARE EXTENSION PROGRAMAnticipating these challenges to primary care transformation, the ACA authorized the Agency for Healthcare Research and Quality (AHRQ) to create a national the PCEP. This section of the law states that the principal charge of the PCEP is to "assist primary care providers to implement a patient-centered medical home to improve the accessibility, quality, and effi ciency of primary care services" through local deployment of community-based Health Extension Agents. In addition to their practice facilitation roles, these agents may "collaborate with local health departments, community health centers, tribes and tribal entities, and other community agencies to identify community health priorities and local health 7 This Institute of Medicine study specifi cally mentions the PCEP as an important model for developing these partnerships. Roots in the Department of Agriculture's Cooperative ExtensionThe PCEP builds upon...

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“…29 This funding would support strategic training partnerships that help draw health professions students from underserved areas and return them there for portions of their training to build and reinforce relationships that help them choose to return home for their careers. The other aspect of this funding would support trainee participation in communityoriented primary care projects to include community defi nition, characterization, engagement, intervention, and evaluation.…”

Section: T I T L E V Ii Funding a Nd Pr Im A Ry C A R Ementioning

confidence: 99%

The Next Phase of Title VII Funding for Training Primary Care Physicians for America's Health Care Needs

Phillips¹,

Turner²

2012

The Annals of Family Medicine

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Health care reform will add millions of Americans to the ranks of the insured; however, their access to health care is threatened by a deep decline in the production of primary care physicians. Poorer access to primary care risks poorer health outcomes and higher costs. Meeting this increased demand requires a major investment in primary care training. Title VII, Section 747 of the Public Health Service Act previously supported the growth of the health care workforce but has been severely cut over the past 2 decades. New and expanded Title VII initiatives are required to increase the production of primary care physicians; establish high-functioning academic, community-based training practices; increase the supply of well-trained primary care faculty; foster innovation and rigorous evaluation of these programs; and ultimately to improve the responsiveness of teaching hospitals to community needs. To accomplish these goals, Congress should act on the Council on Graduate Medical Education's recommendation to increase funding for Title VII, Section 747 roughly 14-fold to $560 million annually. This amount represents a small investment in light of the billions that Medicare currently spends to support graduate medical education, and both should be held to account for meeting physician workforce needs. Expansion of Title VII, Section 747 with the goal of improving access to primary care would be an important part of a needed, broader effort to counter the decline of primary care. Failure to launch such a national primary care workforce revitalization program will put the health and economic viability of our nation at risk. Ann Fam Med 2012;10:163-168. doi:10.1370/afm.1367. INTRODUCTIONT he Patient Protection and Affordable Care Act (P.L.111-1148) (ACA) will provide health care coverage to nearly all Americans, but it did not go far enough to assure access to appropriate care. Despite providing for expansion of community health centers and the National Health Service Corps, the ACA did not do enough to reverse a serious decline in production of primary care workforce. Cautionary evidence to support this concern comes from the universal health care initiative in Massachusetts, where, despite having one of the nation's highest ratios of primary care physicians to the resident population, the newly insured were generally unable to access primary care physicians. 1The ACA contained some important provisions to shore up primary care, including primary care incentive payments, a preference for primary care if unfi lled residency positions are redistributed, authorization and funding for Teaching Health Centers, extension of Medicare Graduate Medical Education (GME) payments for training in nonhospital settings, and increase in Medicaid rates to 100% of Medicare for primary care physicians. 164 T I T L E V II FUNDING A ND PR IM A RY C A R Eexpand primary care physician positions.2,3 All these initiatives are useful, but health care reform demands a much larger and more focused policy effort to produce a greater numbe...

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Health Extension in New Mexico: An Academic Health Center and the Social Determinants of Disease

Cited by 45 publications

References 13 publications

"A Paradox Persists When the Paradigm Is Wrong": Pisacano Scholars' Reflections from the Inaugural Starfield Summit

"A Paradox Persists When the Paradigm Is Wrong": Pisacano Scholars' Reflections from the Inaugural Starfield Summit

The Primary Care Extension Program: A Catalyst for Change

The Next Phase of Title VII Funding for Training Primary Care Physicians for America's Health Care Needs

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