Achieving Effective Team-Based Primary Care in an Age of MACRA & Measurement

Topic Overview

Over a much celebrated career of research, Dr. Barbara Starfield revealed that primary care-oriented health systems have better population health outcomes, higher quality care, greater health equity, and lower costs. Her prolific work supported the idea that first contact, coordinated, continuous, comprehensive primary care was as a path towards achieving these outcomes, now labeled the ‘Triple Aim’ for U.S. health care.

Starfield’s heirs have lamented how poorly health care payment system in this country serves team-based primary care capable of delivering on this robust Primary Care function. The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 promises substantive changes in federal payment for health care, including a push towards paying for measurable value and alternative payment models aimed at achieving population health. But what will this new age of measurement mean for team-based primary care? 


Kurt Stange, MD, PhD

Kurt Stange is a family and public health physician, practicing at Neighborhood Family Practice, a federally-qualified community health center in Cleveland, Ohio. He is the Gertrude Donnelly Hess, MD, Professor of Oncology Research and a professor of Family Medicine and Community Health, Epidemiology & Biostatistics, Oncology and Sociology at  At Case Western Reserve University. He is an American Cancer Society Clinical Research Professor, and serves as editor for the Annals of Family Medicine.
He is currently working on the Promoting Health Across Boundaries initiative and is active in practice-based, multi-method, participatory research and development that aims to understand and improve primary health care and community health.

Amanda Howe, MA, MD, Med FRCGP

Amanda Howe is a practicing family doctor, an academic professor, and a national and international leader in family medicine. Since 2001, she has been Professor of Primary Care at the University of East Anglia, where she was part of the founding team for a new medical program. During her career, she has held multiple roles in undergraduate, postgraduate, and faculty education, including being Course Director for the UEA medical program during its early years of development and accreditation. She has particular expertise in the teaching and learning of professionalism and patient safety; in the models and effectiveness of involving family medicine in community based medical education; and in resilience and doctors’ wellbeing. She also has clinical research interests in primary care mental health, the contribution of patients to health care, and in early interventions for risk factors. She served from 2009 as an Officer of the Royal College of General Practitioners, previously chairing their research committee and the U.K. Society for Academic Primary Care. She is currently the President-Elect of the World Organization of Family Doctors.

Erin E. Sullivan. PhD

Erin E. Sullivan is the Research and Curriculum Director at the Harvard Medical School Center for Primary Care. In this role, Erin leads the Center’s research program, where her team studies high-functioning domestic and international primary care systems. She also holds a faculty appointment in the Department of Global Health and Social Medicine and co-directs the Physician as Leader course for fourth year medical students.
Prior to joining the Center, Erin worked at the Global Health Delivery Project at Harvard University, focusing on developing a Master’s level global health curriculum before moving on to direct a series of mixed methods health systems studies focused on HIV, TB and malaria programs in resource-limited settings. While at the Global Health Delivery Project, Erin also co-directed the management seminar within the Global Health Effectiveness Program at Harvard’s School of Public Health and served as a Faculty Member for Global Entrepreneurship Lab GHD, MIT Sloan’s flagship international project-based class.

For further information, view documents and presentations from the Starfield Summit(