Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM on Bluesky
  • JABFM On Facebook
  • JABFM On Twitter
  • JABFM On YouTube
Research ArticleSpecial Communications

How Evolving United States Payment Models Influence Primary Care and Its Impact on the Quadruple Aim

Brian Park, Stephanie B. Gold, Andrew Bazemore and Winston Liaw
The Journal of the American Board of Family Medicine July 2018, 31 (4) 588-604; DOI: https://doi.org/10.3122/jabfm.2018.04.170388
Brian Park
From the Department of Family Medicine, Oregon Health & Science University, Portland, OR (BP); Eugene S. Farley, Jr. Health Policy Center, University of Colorado School of Medicine, Denver, CO (SBG); Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, D.C. (AB, WL).
MD, MPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Stephanie B. Gold
From the Department of Family Medicine, Oregon Health & Science University, Portland, OR (BP); Eugene S. Farley, Jr. Health Policy Center, University of Colorado School of Medicine, Denver, CO (SBG); Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, D.C. (AB, WL).
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Andrew Bazemore
From the Department of Family Medicine, Oregon Health & Science University, Portland, OR (BP); Eugene S. Farley, Jr. Health Policy Center, University of Colorado School of Medicine, Denver, CO (SBG); Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, D.C. (AB, WL).
MD, MPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Winston Liaw
From the Department of Family Medicine, Oregon Health & Science University, Portland, OR (BP); Eugene S. Farley, Jr. Health Policy Center, University of Colorado School of Medicine, Denver, CO (SBG); Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, D.C. (AB, WL).
MD, MPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

Abstract

Introduction: Prior research has demonstrated the associations between a strong primary care foundation with improved Quadruple Aim outcomes. The prevailing fee-for-service payment system in the United States reinforces the volume of services over value-based care, thereby devaluing primary care, and obstructing the health care system from attaining the Quadruple Aim. By supporting a shift from volume-based to value-based payment models, the Medicare Access and Children's Health Insurance Program Reauthorization Act may help fortify the role of primary care. This narrative review proposes a taxonomy of the major health care payment models, reviewing their ability to uphold the functions of primary care, and their impacts across the Quadruple Aim.

Methods: An Ovid MEDLINE search and expert opinion from members of the Family Medicine for America's Health payment and research tactic teams were used. Titles and abstracts were reviewed for relevance to the topic, and expert opinion further narrowed the literature for inclusion to timely and relevant articles.

Findings: No payment model demonstrates consistent benefits across the Quadruple Aim across a limited evidence base. Several cross-cutting lessons from available payment models several recommendations for primary care payment models, including the following: implementing per member per month–based models, validating risk-adjustment tools, increasing investments in integrated behavioral health and social services, and connecting payments to patient-oriented and primary care-oriented metrics. Along with ongoing research in emerging payment models, data systems integrated across health care and social services settings using metrics that can capture the ideal functions of primary care will be critical to the development of future payment models that most optimally enhance the role of primary care in the United States.

Conclusions: Although the ideal payment model for primary care remains to be determined, lessons learned from existing payment models can help guide the shift from volume-based to value-based care. To most effectively pay for primary care, future payment models should invest in a primary care infrastructure, one that supports team-based, community-oriented care, and measures the delivery of the functions of primary care.

  • Delivery of Health Care
  • Family Medicine
  • Health Expenditures
  • Primary Health Care
View Full Text
PreviousNext
Back to top

In this issue

The Journal of the American Board of Family     Medicine: 31 (4)
The Journal of the American Board of Family Medicine
Vol. 31, Issue 4
July-August 2018
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Board of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
How Evolving United States Payment Models Influence Primary Care and Its Impact on the Quadruple Aim
(Your Name) has sent you a message from American Board of Family Medicine
(Your Name) thought you would like to see the American Board of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
7 + 11 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
How Evolving United States Payment Models Influence Primary Care and Its Impact on the Quadruple Aim
Brian Park, Stephanie B. Gold, Andrew Bazemore, Winston Liaw
The Journal of the American Board of Family Medicine Jul 2018, 31 (4) 588-604; DOI: 10.3122/jabfm.2018.04.170388

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
How Evolving United States Payment Models Influence Primary Care and Its Impact on the Quadruple Aim
Brian Park, Stephanie B. Gold, Andrew Bazemore, Winston Liaw
The Journal of the American Board of Family Medicine Jul 2018, 31 (4) 588-604; DOI: 10.3122/jabfm.2018.04.170388
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Methods
    • Results
    • Discussion
    • Conclusion
    • Acknowledgments
    • Notes
    • References
  • Figures & Data
  • References
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Shifting Implementation Science Theory to Empower Primary Care Practices
  • Re: How Evolving United States Payment Models Influence Primary Care and its Impact on the Quadruple Aim: The Need for Health Equity
  • The Potpourri of Family Medicine, in Sickness and in Health
  • Google Scholar

More in this TOC Section

  • Integrating Community and Clinical Data to Assess Patient Risks with A Population Health Assessment Engine (PHATE)
  • Primary Care Is an Essential Ingredient to a Successful Population Health Improvement Strategy
  • Hepatitis C Update and Expanding the Role of Primary Care
Show more Special Communications

Similar Articles

Keywords

  • Delivery of Health Care
  • Family Medicine
  • Health Expenditures
  • Primary Health Care

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2025 American Board of Family Medicine

Powered by HighWire