About CHRT

Exploring public health and primary care integration opportunities and challenges

October 2022 – April 2023
Funder: The Commonwealth Fund

Public health has been poorly integrated with our medical care and social systems, limiting the ability to deliver effective, timely and equitable services across population groups. While there have been concerted efforts to analyze and recommend improvements to federal-level public health efforts, there is need to focus more specifically on state-level opportunities for increased effectiveness of public health, in particular, approaches for better coordination and collaboration with primary care, medical care systems and community-based organizations.

CHRT’s role:

CHRT will gather perspectives on the barriers and facilitators to better coordination and integration of public health and primary care.

This project builds on previous pilot work funded by the ABIM Foundation and conducted between August 2021 and October 2021. In the pilot, the team conducted semi-structured interviews with leaders in public health and primary care across the country. Preliminary findings from that work indicated that several states had taken innovative approaches to such integration while others had identified the need for more coordination but had not yet taken systemic steps to strengthen the connections between the medical care and public health systems. The goal of the present project is to deepen these preliminary state assessments with a focus on the states that have taken concrete steps to strengthen ties between public health and primary care.

The project will begin with a landscape analysis of current public health and primary care integration efforts at state and local levels across the country. Then, the team will conduct interviews with experts and leaders, focusing on trust and integration efforts between public health and primary care. Finally, CHRT staff will develop detailed case studies of 3 innovative states–North Carolina, Washington, and Rhode Island–to illuminate which strategies, tools, and policy levers were used in these states and a detailed case study of Michigan, an early-stage state to identify strategies being contemplated and potential paths forward to begin the integration and coordination journey. Finally, findings will be used to develop a resource that includes action items and recommendations that can be employed at the state and local levels to catalyze integration of public health and primary care systems.