Recent passage of the Patient Protection and Affordable Care Act was only a starting point in reforming the health care system in the United States. As guidelines and regulations are developed, many health policy experts note that actual implementation of the law will not work without the ability to bend the health care cost curve. And that cannot be accomplished without a greater emphasis on prevention and primary care, making these two components essential to the ultimate success of affordable health insurance reform. The new law (at the THOMAS Web site, type "H.R. 3590" in the search field after selecting "Bill Number") contains a number of measures designed to boost the provision of and payment for primary care services. According to analysts interviewed by AAFP News Now, implementation of these measures should lead to a greater role for primary care and family physicians in the U.S. health care system. "We are going to need every arrow in the quiver, and primary care and prevention are two of the strongest," said Len Nichols, Ph.D., director of the Center for Health Policy Research and Ethics and professor of health policy for the College of Health and Human Services at George Mason University in Fairfax, Va. "They are the foundations on which we have to build." The health care reform law also will increase Medicaid payments for primary care services, bringing them up to the same level as Medicare payments in 2013 and 2014. That provision will affect primary care physicians differently depending on the state in which they live, said Phillips.
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