National Academies of Sciences, Engineering, and Medicine Standing Committee on Primary Care: An Objective Venue to Inform Policy

• Health Policy
• Primary Health Care

The 2021 National Academies of Sciences, Engineering, and Medicine (NASEM) report, Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care, outlined an implementation framework with recommendations for federal, state, and local policy makers, health systems, educational institutions, the interprofessional workforce, and others across the health care ecosystem to ensure that high-quality primary care is available for everyone in the United States.¹ Based on 1 of the report’s recommendations, the Department of Health and Human Services (HHS), in collaboration with the Department of Veterans Affairs and the Department of Agriculture, launched the Initiative to Strengthen Primary Health Care in September of 2021 to coordinate and prioritize primary care activities across the federal government.² In 2023, HHS also published an issue brief documenting the recent primary care activities across agencies that underscores its ongoing commitment to strengthening primary health care efforts across government.³ Formation of this federal coordinating body and the recent progress at the federal level are steps in the right direction to improve primary care in the US, but it is equally important to enable external experts in primary care policy, research, and clinical care to provide input on urgent needs and priorities as primary care policy evolves. The newly launched NASEM Standing Committee on Primary Care,⁴ comprised of clinicians and other professionals with expertise in primary care delivery; clinician training and education; health care administration; health disparities; technologies for health care innovation (eg, AI and telehealth); federal, state and local health care and public health programs; health care finance; health care policy; and integrated team-based health care delivery across settings, will serve this role.¹ The Standing Committee will provide a venue for input that is independent, objective, and evidence-based to inform policy, spark progress and innovation, and confront challenging issues facing primary care today and in the future.

Unlike NASEM consensus study committees that often deliberate in closed session and issue broad and comprehensive reports that typically include findings, conclusions, and recommendations (such as the Implementing High-Quality Primary Care report), NASEM standing committees are ongoing activities with more public interactions that shine a national spotlight on a specific topic area. The Standing Committee on Primary Care plans to host public meetings with invited panelists and stakeholder discussions and may issue short letter reports on focused topics to help inform the field and the Initiative for Primary Health Care. The standing committee will have the ability to produce these short, focused, topic-specific consensus reports with recommendations in response to federal primary care priorities, questions from sponsors, as well as the latest research and emerging changes in primary care policy and practice around the country.

The launch of the federal Initiative to Strengthen Primary Health Care is a remarkable sign of progress. There are also other signals, such as the Centers for Medicare and Medicaid Services’ launch of the Making Care Primary Model⁵ and the aforementioned HHS Issue Brief,³ that demonstrate that the federal government recognizes that a strong system for delivering high-quality primary care that is accessible to all is critical to ensure the health of the nation. In the past, public policy, especially at the federal level, has largely overlooked primary care, despite it being the only health care service associated with improved population health status and greater health equity.¹

The Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care report stated that primary care should be treated as a common good, with strong, coordinated, and effective public policy at all levels, especially within federal government. The Initiative to Strengthen Primary Health Care is a vital first step in the right direction. There is, however, a critical role to play for an impartial, independent entity to provide timely, evidence-based responses to emerging questions and provide input on policy priorities. This will help ensure that policy development and implementation decisions address the real-world primary care delivery needs and reflect the latest research across all policy domains. Because NASEM standing committees can be formulated to comply with section 15 of the Federal Advisory Committee Act (FACA)², the Standing Committee on Primary Care is ideally situated to serve in this role. One major advantage of a NASEM standing committee is its ability to provide input on specific policy questions posed by sponsors or others on a short timeline. The standing committee can serve as a systematic and regular source of input or feedback on planned actions before they are implemented, through the Initiative to Strengthen Primary Health Care and beyond. It provides a transparent mechanism for stakeholder participation and a layer of accountability that will inform smart, evidence-based, and innovative policy implementation that reflects the realities and best practices and will be an important contribution to making high-quality primary care more accessible to all people across the United States.

• Received for publication October 25, 2023.
• Revision received December 5, 2023.
• Accepted for publication December 11, 2023.