• E Marshall Brooks, Alison Huffstetler, Jacqueline Britz, Benjamin Webel, Lail KashiriPaulettePFrom the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (EMB, AH, JB, BW, PLK, AR, RS, KO, TK, AHK); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR,, Alicia Richards, Roy Sabo, Kristen O'Loughlin, Peter Cunningham, Andrew Barnes, Tony Kuzel, and Alex H Krist.
• From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (EMB, AH, JB, BW, PLK, AR, RS, KO, TK, AHK); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RS); Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (PC, AB); Department of Psychology, Virginia Commonwealth University, Richmond. VA (KO).
• J Am Board Fam Med. 2021 Nov 1; 34 (6): 118912021189-1202.

BackgroundPrimary care is crucial to the health of individuals and communities, but it faces numerous structural and systemic challenges. Our study assessed the state of primary care in Virginia to prepare for Medicaid expansion. It also provides insight into the frontline of health care prior to an unprecedented global COVID-19 pandemic.MethodsWe surveyed 1622 primary care practices to understand organizational characteristics, scope of care, capacity, and organizational stress.ResultsPractices (484) varied in type, ownership, location, and care for medically underserved and diverse patient populations. Most practices accepted uninsured and Medicaid patients. Practices reported a broad scope of care, including offering behavioral health and medication-assisted therapy for opioid addiction. Over half addressed social needs like transportation and unstable housing. One in three practices experienced a significant stress in 2019, prepandemic, and only 18.8% of practices anticipated a stress in 2020.ConclusionsPrimary care serves as the foundation of our health care system and is an essential service, but it is severely stressed, under-resourced, and overburdened in the best of times. Primary care needs strategic workforce planning, adequate access to resources, and financial investment to sustain its value and innovation.© Copyright 2021 by the American Board of Family Medicine.

18 keywords...

hide…