Rebuilding the foundation: recommendations from the Summit to Revitalize Primary Care (Rev PC)

In 2021, an ad hoc committee of the United States (U.S.) National Academies of Science, Engineering, and Medicine (NASEM) affirmed that robust, relationship-centered primary care is the foundation of efficient, effective health care. Yet the ad hoc committee also noted primary care was "slowly dying," due to chronic under-investment, ill-suited payment models, and inadequate workforce planning and development. Encouragingly, efforts to revitalize primary care are underway. To accelerate this movement by generating expert consensus recommendations on the highest priority actions to take in repairing the frayed U.S. primary care base, clinical scientists at the University of California Davis (UCD) School of Medicine convened the Summit to Revitalize Primary Care (Rev PC). Summit recommendations were generated in four closed working sessions of a national Expert Committee. Committee members were selected to ensure a breadth of perspectives (e.g., health plans, purchasers of insurance, regulatory agencies, health systems, clinicians, educators, researchers, economists) from the public and private sectors. Seven high priority recommendations emerged: (1) Increase the proportion of spending on primary care, coupled with initiatives to slow the growth in total health care spending; (2) Pay for primary care using models that support high quality, team-based, relationship-centered, equitable care; (3) Assist practices in transformation to advanced primary care models and assess the impacts on clinical teams, patients, and communities; (4) Maximize primary care's potential to equitably advance health; (5) Advocate for training an appropriately large and diverse primary care physician workforce; (6) Expand research to address the most pressing issues in primary care; (7) Collaborate with a broad array of societal stakeholders in messaging the importance of robust primary care. These recommendations both overlap with and expand on those of the NASEM ad hoc committee and subsequent Standing Committee on Primary Care. Broad pursuit of the recommendations would catalyze sustained momentum toward appropriate primary care investment and workforce planning and development, enabling U.S. primary care to realize its yet-unfulfilled potential to improve population health and advance health equity while helping to control growth in total health care costs.