Integrating primary care and public health: A report from the Institute of Medicine

In response to a joint request from the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA), and with additional funding from the United Health Foundation, the Institute of Medicine (IOM) convened a committee of experts to examine the integration of primary care and public health. The report will be publicly released in the spring of 2012. Panel members, including representatives from the committee and sponsors, will discuss the report and its implications.

Why is the integration of primary care and public health important and timely? Several landmark reports, including the IOM's 1996 report, Primary Care: America's Health in a New Era, and the IOM's 2003 report, The Future of the Public's Health in the 21st Century, clearly identified the need to bridge the chasm between primary care and public health. Furthermore, the Affordable Care Act (ACA) has redefined the national conversation on health. The ACA is premised upon the principle embedded in Healthy People 2010 that "the health of the individual is almost inseparable from the health of the larger community and that the health of every community in every State and territory determines the overall health status of the Nation." The significant investments the ACA makes in both primary care and public health signal the opportunity to transform our health system into one that integrates the two fields, from system design to community practice.

As agencies responsible for overseeing the public health of the nation and the provision of primary care for tens of millions of vulnerable individuals, CDC and HRSA are uniquely poised to facilitate the integration of primary care and public health. In their request to the IOM, the sponsors expressed their interest in receiving practical, actionable recommendations that could assist both agencies in establishing linkages with each other and with other relevant stakeholders. The statement of task specifically asks the committee to focus on: • Demonstrated, shared accountability for population health improvement; • Optimal integration of the public health and primary care workforce; • Collaborative governance, financing, and care coordination models; and • Effective use of health information technology.

In response to the request, the IOM convened a 17-member committee with experts in primary health care, state and local public health, service integration, health disparities, health information technology, health care finance, health care policy, public health law, workforce education and training, organizational management, and child health.