For many years, efforts to reduce health care costs and improve quality have largely hinged on linking health care payment to performance using broad measures of cost management (e.g., total cost of care, bundled payments built around conditions or procedures), as well as readily available quality measures. To date, quality measures used to evaluate performance have primarily focused on the process of managing specific diseases and performing specific tasks. This has resulted in a multitude of measures and approaches that have become increasingly burdensome on those delivering care. In addition, this piecemeal approach to measurement does not adequately or accurately capture the whole-person, complex nature of primary care.
The American Academy of Family Physicians (AAFP) believes that quality measures, whether used for internal quality improvement or tied to payment, should focus on the unique features of primary care (www.aafp.org/vision-qm). These features are aligned with the functions of advanced primary care (i.e., access and continuity, planned care and population health, care management, patient and caregiver engagement, and comprehensiveness and coordination) and are known to drive better patient outcomes and lower costs.
In 2015, the Larry A. Green Center—a research center focused on advancing primary health care for the public good—undertook the daunting task of developing a new way to measure primary care. The Green Center conducted extensive research, including surveying patients, primary care physicians, and employers. They also engaged experts from across the health care industry. The result is the Person-Centered Primary Care Measure Patient Reported Outcome Performance Measure (PCPCM PRO-PM) (www.green-center.org/pcpcm). Patient-reported outcomes recognize the patient as a knowledgeable informant on many important aspects of primary care and support personalized care, which is valued by patients, physicians, health plans, and employers.