Texas in June is hot, humid, and buggy, meaning locals tend to spend it poolside or inside, not on a road trip through Central Texas, despite the region’s charm and scenic beauty.

But if you’re on a mission to improve access to primary care for your beneficiaries, then wilting heat, hair-frizzing humidity, and mosquitoes won’t stop you.

For five days in June, senior national and regional leaders from the Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), and the Health Resources and Services Administration (HRSA), traveled through Central Texas, Dallas to San Antonio, with a three-fold purpose:

• Educate constituents on their rural and primary care-focused initiatives.
• Gather insight from stakeholders about the challenges they face keeping their doors open to Medicare and Medicaid patients.
• Identify potential regulatory reforms within each agency’s purview to address these challenges, while also fostering greater coordination, collaboration, and innovation in primary and rural health care

Over the years, Texas Primary Care Consortium (TPCC) co-leaders, Sue Bornstein, MD, MACP, and Ankit Sanghavi, MPH, BDS, have actively cultivated a relationship with CMS’s regional leadership, giving TPCC an opportunity to highlight its growing portfolio of educational and policy initiatives aimed at advancing its goal to make primary care primary.

As a result of this rapport, CMS invited TPCC to co-host a listening session, giving both CMS and the consortium an opportunity to engage a wider audience of rural and primary care thought leaders.

Thus, at a full house in Austin on June 26, physicians, nurses, and leaders from federally qualified health centers, hospitals, academia, insurers, foundations, research institutes, and state agencies gathered to hear how primary care innovators are developing and deploying home-grown solutions to address the issues they and their patients face.

Initiatives included building an electronic decision-support tool to help primary care physicians more confidently diagnose and manage patients with mental health conditions; strengthening maternal health services through care coordination and improved home monitoring; and recruiting and retaining the next generation of rural primary care clinicians.

When it came time to share threats facing primary care, participants were not shy in their answers, though none were surprising. Falling reimbursement, rising overhead costs, time-wasting administrative hassles, workforce, workforce, workforce, balkanized health information, and the desertification of rural maternity and primary care services. However, participants also strongly believed primary care must be strengthened and expressed a genuine interest—and need—for stakeholders and CMS to collaborate to develop solutions.

While no solutions emerged at this meeting, CMS did what it purported to do, actively listen.  The agency left with copious notes in hand, and genuine commitment to continue the conversation around potential policy changes that are needed to improve primary care.

HHS also conveyed its priority to improve interagency communication and collaboration, with the goal of promoting more informed and consistent policy proposals, regulations, and guidance. Moreover, it committed to getting back on the road—literally and figuratively—to build upon what it gleaned on this trip.

We are excited to announce that our collaboration will continue with a series of CMS-hosted roundtable sessions featuring key topics around advancing primary care in our state.

We foresee many Buc-ee’s pitstops in CMS’s near future!

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Helen Kent Davis

Senior Associate - Health Policy, Texas Health Institute

Founder and Principal, HKD and Associates