1. University of Nebraska Medical Center PRIMARY CARE Definitions Millis Commission – 1966 First-contact, continuing, and comprehensive care Institute of Medicine – 1996 Integrated, high quality, accessible care by clinicians accountable for majority of care needs, in context of family and community Macy Foundation Conference – 2010 24/7 accessibility, accountable teams of professionals, personal health care needs, defined panel of patients, monitoring quality, working within systems

2. University of Nebraska Medical Center PRIMARY CARE MACY FOUNDATION CONFERENCE January 2010 CONCLUSION l Need to incentivize ways to value primary care through training Recommendations 1. Create financial and other incentives to develop innovative primary care models such as best- practice centers of excellence 2. Increase workforce and remove policy and regulatory barriers to APNs and PAs

3. University of Nebraska Medical Center PRIMARY CARE MACY FOUNDATION CONFERENCE January 2010 CONCLUSION l Recommendations (continued) 3. Promote stronger ties between AHCs and other primary care sites, assure quality and cost accountability 4. Invest in primary care HITs 5. Reform payment to value primary care, prevention and care co-ordination, standardize insurance forms

4. University of Nebraska Medical Center PRIMARY CARE MACY FOUNDATION CONFERENCE January 2010 CONCLUSION ll New educational models Recommendations 1. AHCs with CHCs and AHECs to innovate projects of advanced interprofessional care 2. Increase, strengthen and diversify the workforce, early exposure to community practices, primary care tracks

5. University of Nebraska Medical Center PRIMARY CARE MACY FOUNDATION CONFERENCE January 2010 CONCLUSION ll New educational models Recommendations (continued) 3. Eliminate regulatory accreditation, reimbursement and other barriers to interprofessional education 4. Expand Title VII and VIII, Medicare GME, and AHEC funding for faculty and students

6. University of Nebraska Medical Center PRIMARY CARE MACY FOUNDATION CONFERENCE January 2010 CONCLUSION lIl Leadership development- clinicians and policymakers Recommendations 1. Focus on advancing curricula and learning opportunities, partner with business and law to join in improvement and policy 2. Support science of translation of best practices into patient and community health, via career development, national metrics, and targeted awards 3. Include representatives of all provider professions in leadership of delivery systems and policy making