About CHRT

Integrating public health and primary care: Designing a demonstration project to strengthen systems

June 2021 – May 2022
Client(s): American Board of Internal Medicine (ABIM) Foundation

The lack of connection between primary care and public health has had serious consequences during the COVID-19 pandemic. Public health messages about the measures necessary to keep people safe–masking, social distancing, the need for internal eating closures, and the like–have been politicized, and in many communities, public health leaders had difficulty getting these messages heard and accepted.

Physicians’ are trusted messengers of health information, but too many consumers are not hearing their public health-related messages, particularly those from primary care physicians. Lives would almost certainly have been saved during the pandemic had primary care physicians and public health leaders worked together to share public health guidelines and reinforce messages.

CHRT’s role:

This project aims to:
– Identify ways to integrate public health and primary care and develop sustainable funding mechanisms to strengthen both systems
– Explore how community organizations can support public health and primary care integration
– Determine the services from both primary care and public health which will be most feasible and impactful in an integrated model
– Learn from existing models of primary care teams that incorporate public health, with particular attention to information sharing and SDoH services
– Explore how a collaborative effort could be supported through public and private payers
– Prepare what a pilot or demonstration project might look like for future funding
– Build on previous work in this area, such as pilots supported by the U.S. Centers for Medicare and Medicaid Services.

The project workgroup plans to explore the above issues through three phases of work:
1) The first phase will focus on key informant interviews with representatives from a range of organizations and entities such as public health and primary care professionals from states with advanced integrated systems and from states identified by the National Health Security Index 2020.
2) The second phase of work will be to hold focus groups with key stakeholders including organizations representing marginalized communities’ health interests. Learnings from the key informant interviews described above will be used to develop messages, materials, and concepts that can be shared with the focus groups for feedback.
3) The third phase of work will be to develop a model for a pilot based on the findings from the key informant interviews, the strategies developed from the focus groups, and the designs being used to address health equity by the U.S. Centers for Medicare and Medicaid Services Administration.