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UCSF expert outlines '10 building blocks' for high‑performing primary care and urges investment
Summary
Dr. Mariana Kong (UCSF) told the board that patient-centered medical homes and the '10 building blocks' for primary care can improve quality and lower costs but require investment, team-based staffing and alternative payment models such as care coordination fees and shared savings.
Dr. Mariana Kong, a physician with the UCSF Center for Excellence in Primary Care, told the San Francisco Health Service Board that patient-centered medical homes (PCMH) and primary-care transformation are central to improving population health and controlling costs.
Kong described the Center’s ‘‘10 building blocks’’ of high-performing primary care—including empanelment, team-based care, population-based management, care coordination and a ‘‘template of the future’’ that supports non‑visit work—and said accreditation (for example, NCQA recognition) is one signal of capability but not a guarantee of real-world performance. She described evidence linking stronger primary-care supply to better quality and lower spending, and reviewed payment and support models (blended payment, care-coordination fees, CPC+).
Why it matters: SFHSS population health and cost-control goals depend in part on accessible primary care and stronger primary‑care capacity in the region. Kong emphasized that meaningful transformation requires funding for team staff, practice facilitation and data/registry systems.
Details and board feedback: Kong summarized pilot examples (UCSF Health’s PCMH work, Medicaid/Medicare initiatives like CPC+) and stressed that many clinics lack empanelment or reliable registries, which hampers population management. Board members asked about staff cross‑coverage, empirical panel definitions and how to identify high-functioning practices; Kong recommended standardized protocols, cross‑training, and use of NCQA listings as a starting point while acknowledging high-performing clinics may not always seek accreditation.
Public comment and closing: Multiple public commenters commended the presentation and suggested leveraging SFHSS data and emergency planning contexts. The item remained informational; board members asked staff to keep the 10 building blocks as a reference if the board revisits PCMH-related investments.
