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Abstract
There is unprecedented national dialogue taking place on the future of our health care system. It is probable that there will be more health care legislation and system reform in the next several years than in any period in our history. Reform must address a fractured health care system and eliminate gaps in care caused by an ineffectual communication processes. Integration of the health care system must occur to improve accessibility, coordination, continuity, and communication between providers and with patients. Changes will include increasing patient access to health care services and greater use of prevention and wellness programs, which are critical to controlling future costs. However, this transformation requires significant expansion of our existing primary care provider base.
In response to this reformation process, the Connecticut Center for Primary Care (CCPC) organized and hosted annual Primary Care Summits in November 2008 and December 2009. National experts in primary care reform delivered presentations on a new paradigm for primary care. These conferences provided the framework for new strategies and were a catalyst for new relationships that ultimately led to a statewide alliance for the improvement of primary care. This alliance. The Primary Care Coalition of Connecticut (PCCC or The Coalition) serves as an advocate to the public, a resource to legislative and payer policy makers, and a focal point for activity to improve the existing primary care base. Coalition members come from diverse backgrounds, including physicians, nurse practitioners, physician assistants, public health workers, community health centers, government health programs, and private medical practices. They united to help build and promote a more effective system of primary health care for Connecticut.The Coalition believes that for any reform of the health care system to be successful, the system must be restructured with primary care as the focus.
The Coalition's original goal was to ensure that primary care is the foundation of any health care reform proposal in Connecticut and that each proposal includes necessary language to reform payment, workforce, and definitions of providers and services.
The initial meeting of the Coalition was held on January 13, 2009, and included invitees from 10 unique groups, including: Community Health Center, Inc. (CHC), CT Chapter of the American Academy of Pediatrics. Connecticut Academy of Physician Assistants (ConnAPA), Connecticut Academy of Family Physicians (CAFP), ProHealth Physicians, Connecticut Center for Primary Care (CCPC), University of Connecticut (UConn)/St. Francis Family Medicine Residency Program, UConn School of Medicine, Connecticut Chapter of the American College of Physicians (ACP), Connecticut Advanced Practice Registered Nurse Society (CTAPRNS). Refer to Appendix A for further description of the groups. The agenda included discussion of a draft vision statement, an informal environmental scan, brainstorming for next steps, and organizational priorities (such as leadership, location, and administrative support). In addition, the tradition of monthly meetings was established. Guiding principles were created at the time:
the impact of federal initiatives is too remote to wait and action is necessary now on a state level;
for any reform of the health care system to be successful, the system needs to be restructured with primary care as the focus. Thus, the entire health care delivery system needs to be transformed, not just reforming the payment system or providingthe revised model needs to include designing a delivery system based on quality of care, wellness and prevention and coordination of care (often referred to as a "medical home model" or "health care home"), addressing the primary care manpower deficit, redesigning the payment system, leveraging technology and organizational infrastructure, and collaborating with the Connecticut legislature on a more cost efficient and effective health care system.
Approximately 20 months passed between the initial meeting and the beginning of the health policy internship with the Coalition. In that time, new members were introduced, and meetings were held with key stakeholders, including the Department of Public Health, state legislators, and employers. Meetings were also held with representatives from other state Coalitions in the region, including New York, Massachusetts, and Maine, to learn from their experiences. A Steering Committee was proposed in January 2010 to further guide organizational development. but never met.
