more than 13 states will be involved in PCEP efforts over the next 2 years (AHRQ, 2010). Fully fledged, the PCEP could function through grants received by PCEP State Hubs and Local Primary Care Extension Agencies. The State Hubs could include state health departments, state Medicaid and Medicare program administrators, and the departments of academic institutions that train providers in primary care. In addition to these entities, State Hubs might include such entities as hospital associations, primary care practice-based research networks, and state primary care associations. Local Primary Care Extension Agencies are required to perform a number of tasks under the ACA. These tasks include assisting primary care providers in implementing the principles of the patient-centered medical home model, developing and supporting primary care learning communities to enhance dissemination of best practices and improve the involvement of local providers in research, and developing a plan for financial sustainability after the scheduled reduction of federal funding.
While the PCEP is the domain of AHRQ, HRSA and CDC have many reasons to work with AHRQ to elevate the PCEP to a priority within HHS and seek collaboration with CMMI to fund PCEP models that evidence shows can improve personal and population health. The ACA expressly mentions that the PCEP could help support health centers, rural health clinics, and National Health Service Corps (NHSC) sites. In addition, the PCEP could be a bridge between primary care and public health in every county of the country. Once more mature, the PCEP could “participate in community-based efforts to address the social and broad determinants of health, strengthen the local primary care workforce, and eliminate health disparities.”21 In working with AHRQ, HRSA and CDC could help ensure that the program includes a public health orientation and integrates community health issues into practice-and clinic-based primary care improvement activities. For these mutual reasons, the three agencies could build a case for why HHS should support the program, and could also provide guidance on the development of measures for evaluating the program’s effectiveness in involving public health in clinical practice.
National Health Service Corps
The NHSC,22 whose loan and scholarship recipients constitute a significant proportion of all health professionals in health center practice, has received an important infusion of funding. Given the goals of clinical preventive services, one important area of collaboration between HRSA and CDC might be in prioritizing the recruitment and placement of NHSC
21ACA § 5405. p. 584.
22ACA § 5207.