Newton Studies Advanced Primary and Value-Based Care
OKLAHOMA CITY – Rep. Carl Newton, R-Cherokee, on Monday held an interim study on the critical role of advanced primary care and value-based care in improving Oklahoman's healthcare outcomes and reducing costs. The study was held before the House Appropriations and Budget Health Subcommittee. "We're concerned about the cost of healthcare and are trying to make all aspects of it more affordable for individuals and taxpayers," Newton said. "When people can afford to access preventative healthcare, they have a better quality of life." Kari Webber, executive vice president of the Oklahoma Academy of Family Physicians and the executive director of the Oklahoma Chapter of the American Academy of Pediatrics, said both organizations are doing everything possible to promote primary care. "One of the things that we know," Webber said, "is that when patients are meeting with primary care physicians, costs of healthcare go down. And when we're doing that preventative care and care coordination models, we know we see impacts not only in the patient and their health outcomes but also the costs of overall care in general." Newton explained in his study request that advanced primary care is a physician-led, team-based model that expands upon traditional primary care by emphasizing prevention, care coordination, enhanced patient access, behavioral health integration and accountability for quality and outcomes. Traditional fee-for-service payment models, however, often do not provide the resources necessary for such care. Advanced primary care and value-based care are complementary strategies. Value-based care rewards providers for improving outcomes and reducing costs, while advanced primary care provides the infrastructure and care management capabilities necessary to achieve those goals. Both have shown to reduce overall healthcare costs by reducing unnecessary treatments and hospitalizations. For the study, Newton drew together healthcare providers representing rural, regional and tribal interests. These included Dr. John Zubialde, senior advisor for the Oklahoma Health Care Authority, Teresa Huggins, CEO of the Stigler Health & Wellness Center, Inc.; Dr. Marty M. Lofgren, and registered nurses Sandra Vaughn and Deana Aissaoui with Absentee Shawnee Tribal Health Systems; Dr. Jesse Campbell, regional physician executive, Sommer Skinner, vice president of Primary Care, and Rachel Allen, a registered nurse and director of operations for Mercy Oklahoma Community. Presenters discussed the successful implementation of advanced primary care, which requires investments in care teams, technology, data analytics, quality reporting and patient outreach. The study further examined whether current payment models adequately support these investments, particularly for independent and rural physician practices. Study presenter Dr. John Zubialde explained the overall need for advanced primary care versus other care models to address those with chronic and more complex healthcare needs. This generally represents the greatest costs to patients, insurers and the public. "When we look at Oklahoma's health statistics compared to national averages," Zubialde said, "we can see that chronic disease prevalence in Oklahoma is substantially above many national averages across the majority of the major measures." Mental health concerns, including depression, and substance abuse disorders, including methamphetamine and opioid use, along with preventable deaths, premature death rates and preventable hospitalizations also are substantially higher than national averages. At the same time, the use of preventive care services are well below the national average. "Oklahoma ranks about mid-tier in per capita health spending," Zubialde said. "That's a positive. However, when you recognize that in terms of per-capita income and resources for the average Oklahoma family, we're in the bottom area." This all translates into some statistics that must be considered, he said. "We're in the top ten states for the steepest health services cost increases. We're in the top ten states for individuals forgoing care because they cannot afford it. Even worse, we're in the top two states for highest medical debt, approximately double the national average, and we're in the top two states for highest rates of uninsured patients." That ranks Oklahoma at about 48th out of 51 states and Washington, D.C. "Broad-based primary care that incorporates advanced primary care has the best chance for helping to change this equation in our state," he said. The study can be watched on the House website under News & Media, live proceedings, search by date for Aug. 24, IS26-035 Advanced Primary Care and Value Based Care in Oklahoma .