CMMI’s New Comprehensive Primary Care Plus: Its Promise And Missed Opportunities

The Center for Medicare and Medicaid Innovation (CMMI) has recently announced an initiative called Comprehensive Primary Care Plus (CPC+), evolved from the previous Comprehensive Primary Care (CPP) initiative. The initiative mainly consists on paying a fee to those primary care practices willing to introduce organizational changes centered in five primary care functions:  (1) access and continuity; (2) care management; (3) comprehensiveness and coordination; (4) patient and caregiver engagement; and, (5) planned care and population health.

In this post, the authors outline some of the promises and downsides of the PCC+. On the bright side, the authors analyse how financial incentives ...

Can hospital services work in primary care settings?

In this post, the author analyzes how recent changes in primary care in the National Health Services could face the purpose of moving some services from hospital to primary care settings.

The author bases her discussion on a report published by RAND corporation (“Outpatient Services and Primary Care”) that identifies five main areas to be considered when moving services from hospital to primary care:

1. Transfer: The substitution of services delivered by specialists for services delivered by primary care clinicians.
2. Relocation: Shifting the venue of specialist care from hospitals to primary care settings.
3. Liaison: Joint working between specialists and primary care ...

No universal health coverage without primary health care

Correspondance

Universal health coverage is currently the aspiration of many countries worldwide. We commend Michael Reich and colleagues for analysing lessons learned from different country experiences, but we believe there is a crucial element neglected within the ongoing universal health coverage debate.

Health-care system development requires more than financing and human resource considerations. Although essential, these components must be integrated into an overall framework for organising and delivering care that best meets population needs. Primary health care provides such a framework, builds the backbone of an effective health-care system, and can improve health, reduce growth in costs, and lower inequality ...

The World report on ageing and health: a policy framework for healthy ageing

Although populations around the world are rapidly ageing, evidence that increasing longevity is being accompanied by an extended period of good health is scarce. A coherent and focused public health response that spans multiple sectors and stakeholders is urgently needed. To guide this global response, WHO has released the first World report on ageing and health, reviewing current knowledge and gaps and providing a public health framework for action. The report is built around a redefinition of healthy ageing that centres on the notion of functional ability: the combination of the intrinsic capacity of the individual, relevant environmental characteristics, and ...

State humanitarian verticalism versus universal health coverage: a century of French international health assistance revisited

The French contribution to global public health over the past two centuries has been marked by a fundamental tension between two approaches: State-provided universal free health care and what we propose to call State humanitarian verticalism. Both approaches have historical roots in French colonialism and have led to successes and failures that continue until the present day. In this paper, the second in The Lancet's Series on France, we look at how this tension has evolved. During the French colonial period (1890s to 1950s), the Indigenous Medical Assistance structure was supposed to bring metropolitan France's model of universal ...

10 Best resources on… intersectionality with an emphasis on low- and middle-income countries

Intersectionality has emerged as an important framework for understanding and responding to health inequities by making visible the fluid and interconnected structures of power that create them. It promotes an understanding of the dynamic nature of the privileges and disadvantages that permeate health systems and affect health. It considers the interaction of different social stratifiers (e.g. 'race'/ ethnicity, indigeneity, gender, class, sexuality, geography, age, disability/ability, migration status, religion) and the power structures that underpin them at multiple levels. In doing so, it is a departure from previous health inequalities research that looked at these forms of social stratification ...

Community participation for transformative action on women's, children's and adolescents' health

The Global strategy for women's, children's and adolescents' health (2016-2030) recognizes that people have a central role in improving their own health. We propose that community participation, particularly communities working together with health services (co-production in health care), will be central for achieving the objectives of the global strategy. Community participation specifically addresses the third of the key objectives: to transform societies so that women, children and adolescents can realize their rights to the highest attainable standards of health and well-being. In this paper, we examine what this implies in practice. We discuss three interdependent areas for action ...

Report on the Global Knowledge Commons for Innovations in mHealth and eHealth

The International Society for Telemedicine & eHealth publishes (in an electronic form) the Report of the Innovation Working Group (IWG) Task Force on the Global Knowledge Commons for m-eHealth Innovations.

The report addresses the key challenge facing digital health, which is that of converting our collective knowledge into a global public good, accessible to all, thus enabling each actor in the ecosystem to benefit from what others know. The document postulates that a Global Knowledge Commons (GKC) for innovation in health or simply "the Commons", would be composed of three main constituents:

• A database of projects, products and services;
• A "Who ...

Can service integration work for universal health coverage? Evidence from around the globe

Universal health coverage (UHC) is at the heart of the new 2030 Agenda for SustainableDevelopment. Health service integration is seen by World Health Organization as an essen-tial requirement to achieve UHC. However, to date the debate on service integration hasfocused on perceived benefits rather than empirical impact. We conducted a global reviewin a systematic manner searching for empirical outcomes of service integration experimentsin UHC countries and those on the path to UHC. Sixty-seven articles and reports were found.We grouped results into a unique integration typology with six categories – medical stafffrom different disciplines; patients and medical staff; care package for ...

Integrated care – taking specialist medical care beyond the hospital walls

The Royal College of Physicians has published in 2016 a document titled “Integrated care -  taking specialist medical care beyond the hospital walls”.

In the first part of this document they are described some of the main topics about integrated care, how it is conceptualize and what it really implies for patients, professionals and for the whole system.

Afterwards, some study cases are shown as examples to go deeper into different dimensions of integrated care such as the need for sustainable models of integrated care, leadership, management and governance or self-management and care.

Finally, the document lists five key areas where ...