HealthDay News — The Primary Care Extension Program (PCEP), a provision of the 2010 Affordable Care Act that was authorized but not funded, has the potential to speed-up the transformation of primary care necessary to meet the goals of health reform, according to members of the American Board of Family Medicine.

The organization is asking for $120 million in annual federal funding to support the program, and say future appropriations should target the $500 million level, in a report recently published in Annals of Family Medicine.

“There is tremendous urgency to accelerate changes in primary care, integrate primary care with public health, and translate research into practice to improve health outcomes, health care and costs,” board member Robert L. Phillips, Jr., MD, and colleagues wrote.

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If funded the PCEP would help primary care practices establish patient-centered medical homes by deploying community-based “Health Extension Agents,” the role of whom would be to collaborate with local health agencies to identify community health priorities and determine the workforce needs to achieve these goals.

PCEP as proposed in the ACA is analogous to the U.S. Department of Agriculture’s (USDA’s) Cooperative Extension Program, which helped speed the modernization of farming one century ago, according to the agency.

“For nearly 100 years, county extension agents worked with farmers to identify their needs, build trust, and translate research-based knowledge emerging from land-grant universities and experimental farms—all to speed adoption of best farming practices,” the researchers wrote, arguing the same is needed for healthcare.

They cited several healthcare programs that support the use of Health Extension Agents, including the University of New Mexico’s Health Extension Rural Office (HERO) program and more than 68 multi-stakeholder patient-centered medical home pilots underway in 25 states. Despite the demonstrated success of such programs, “few have clearly articulated strategies for building and sustaining the infrastructure needed for ongoing practice facilitation,” the researchers wrote.

“Just as no hospital in the United States can rightfully operate without a quality and performance improvement department with dedicated staff and resources, it is unreasonable to expect an entire, foundational component of the health system—the primary care ambulatory sector—to function well without a comparable infrastructure to facilitate improvement and the continuous, adaptive changes that are the hallmarks of high performing organizations,” the researchers concluded.


  1. Phillips RL et al. Ann Fam Med. 2013;11(2):173-178.