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IOM Makes Case for Public Health/Primary Care Integration

April 2, 2012
by Gabriel Perna
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A new report from the Institute of Medicine (IOM) makes the case for integrating primary care healthcare providers and public health professionals. The report says further integration will allow both primary care healthcare providers and public health professionals to meet their goals of ensuring the health of populations.

The IOM report says a successful integration will require national leadership as well as substantial adaptation at the local level.  It has several recommendations for the Centers for Disease Control and Prevention (CDC) and Health Resources and Services Administration (HRSA) to support integration between primary care and public health through funding, policy levers, and other means.  The recommendations come off an IOM review of published papers as well as case studies in specific cities — Durham, N.C.; New York City; and San Francisco — where integration efforts have taken place. 

Successful integration, the report noted, includes community engagement to define and tackle local population health needs; leadership that bridges disciplines and jurisdictions and provides support and accountability; shared data and analyses; and sustained focus by partners. 

The HRSA and CDC are mandated by the Affordable Care Act to launch several new programs, to which the report suggests coordination on their launch. It also recommends funding streams with other partners at the national, state, and local levels to spur momentum.  The report says, the medical home model and the new accountable care organizations (ACOs) also offer opportunities for integration.  As more primary care practices move toward the patient-centered medical home model, the IOM report says public health departments could work with these practices and spread the benefits of care coordination to the community.

The report also mentions how training primary care and public health professionals in aspects of each other's fields would promote integration. It recommends the HRSA and CDC working together to develop training grants and teaching tools that can prepare the next generation of health professionals for shared practice.

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