For patient-centered care to happen, primary care providers and specialists need to talk to each other. If the consultation and referral process isn't done well, complications and bad health outcomes are more likely. There aren't many rules for how oral health should fit into primary care. But the National Academies Roundtable on Health Literacy recently asked for a paper to be written about some of the problems in this area.

One of the most important parts of a successful integrated healthcare system was found to be the referral process. This includes a way for doctors to talk to each other directly, as well as referral rules and educational programs for doctors. There is also a need for better ways to deal with problems with communication and referral. The primary care staff who were in charge of coordinating referrals said it was very hard to talk to specialists. They said they used e-consults and the phone to talk to specialists and often turned down referral requests because they needed too much information.

It's not easy to put a new spin on the mythical multi-specialty referrals or to coordinate care across a medical neighborhood. The benefits of a tiered referral scheme are well known, but many different problems need to be solved to make it work. For example, many health centers don't have the internal coordination needed to build the kind of relationship that would make a tiered referral system work well. In the same way, many centers have not yet learned how to do follow-up well.

The Center for Medicare and Medicaid Innovation just finished a study examining the most important parts of primary care, from the patient to the provider. The resulting report, which includes the results of a nationwide survey, was a treasure trove of information about patient engagement, quality and cost data, and the best practices for health system managers.

Compared to other countries, the U.S. spends more on health care administration, including the costs of running hospitals. In the United States, hospital administrative costs make up 25% of all healthcare costs, while in the Netherlands and England, they only make up 12% and 12%, respectively.

The American College of Physicians backs efforts to lower health care administration costs, like putting more money into primary care services. It also helps with efforts to reduce price differences, especially for services whose prices don't match their costs.

Primary care is an important part of the health of a whole population. It saves money on future care and is essential for finding and treating diseases early on. Recent studies at the state level show that putting more money into primary care cuts down on hospitalizations, outpatient care, and deaths.

A debate continues about whether the U.S. should switch to a model where everyone pays for their health care. Some policymakers support this model, but there are other worries. One is that switching to this kind of model could be too expensive. A second worry is that it would lead to price controls and make it harder for doctors to participate. No matter what, everyone involved must work together to make policies that will improve health while keeping costs down.

The American College of Physicians (ACP) backs several policy changes that would slow spending growth and improve government work. In particular, it backs policies that lower list prices too high and makes premium tax credits more generous. The ACP also backs the creation of a single-payer model, which would be paid for by progressive income taxes, savings made by the whole system, and other ways.

Integrating oral health and primary care can improve the quality of care and make it easier for people to get services. But bridging the gap between these two areas is a very difficult task.

There are different ways to close the gap. For instance, electronic tools can help doctors and nurses share information and refer patients to other specialists. Health literacy programs are another way to do this. Those who know much about health care can speak up for their health.

Another way is to use technology to connect services for oral health and primary care. In particular, the Health Resources and Services Administration is making a core set of oral health clinical competencies for primary care providers in safety net settings. These competencies include communication and education, figuring out the risks, and setting up the right referral systems.