High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels. Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country's primary care services a public concern. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs. Table of Contents Front Matter Abstract Summary 1 A New Vision for Primary Care 2 Defining High-Quality Primary Care Today 3 Primary Care in the United States: A Brief History and Current Trends 4 Person-Centered, Family-Centered, and Community-Oriented Primary Care 5 Integrated Primary Care Delivery 6 Designing Interprofessional Teams and Preparing the Future Primary Care Workforce 7 Digital Health and Primary Care 8 Primary Care Measures and Use: Powerful, Simple, Accountable 9 Payment to Support High-Quality Primary Care 10 Enhancing Research in Primary Care 11 The Committee's Approach to an Implementation Strategy 12 A Plan for Implementing High-Quality Primary Care Appendix A: Committee Member, Fellow, and Staff Biographies Appendix B: Primary Care: America's Health in a New Era Report Recommendations Appendix C: Committee's Calculations to Determine the Impact of the Decreased Density of Primary Care Physicians Between 2005 and 2015 Appendix D: Three System-Level Tables of Actors and Actions Appendix E: The Health of Primary Care: A U.S. Scorecard

Being deployed to a war zone can result in numerous adverse psychological health conditions. It is well documented in the literature that there are high rates of psychological disorders among military personnel serving in Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom in Iraq as well as among the service members' families. For service members' families, the degree of hardship and negative consequences rises with the amount of the service members' exposure to traumatic or life-altering experiences. Adult and child members of the families of service members who experience wartime deployments have been found to be at increased risk for symptoms of psychological disorders and to be more likely to use mental health services. In an effort to provide early recognition and early intervention that meet the psychological health needs of service members and their families, DOD currently screens for many of these conditions at numerous points during the military life cycle, and it is implementing structural interventions that support the improved integration of military line personnel, non-medical caregivers, and clinicians, such as RESPECT-Mil (Re-engineering Systems of Primary Care Treatment in the Military), embedded mental health providers, and the Patient-Centered Medical Home. Preventing Psychological Disorders in Service Members and Their Families evaluates risk and protective factors in military and family populations and suggests that prevention strategies are needed at multiple levels - individual, interpersonal, institutional, community, and societal - in order to address the influence that these factors have on psychological health. This report reviews and critiques reintegration programs and prevention strategies for PTSD, depression, recovery support, and prevention of substance abuse, suicide, and interpersonal violence. Table of Contents Front Matter SUMMARY 1 INTRODUCTION 2 CONCEPTUAL FRAMEWORKS FOR REVIEWING EVIDENCE-BASED PREVENTION IN PSYCHOLOGICAL HEALTH 3 UNDERSTANDING PSYCHOLOGICAL HEALTH IN THE MILITARY 4 EVIDENCE FOR DEPARTMENT OF DEFENSE INTERVENTIONS FOR PREVENTING PSYCHOLOGICAL DISORDERS 5 MEASUREMENT OF DEPARTMENT OF DEFENSE PREVENTION INTERVENTIONS RELATED TO PSYCHOLOGICAL HEALTH 6 FINDINGS AND RECOMMENDATIONS Appendix A: SUMMARY FROM *RETURNING HOME FROM IRAQ AND AFGHANISTAN: ASSESSMENT OF READJUSTMENT NEEDS OF SERVICE MEMBERS AND THEIR FAMILIES* Appendix B: INFORMATION-GATHERING MEETING AGENDA Appendix C: SUPPLEMENTAL HEALTH SCREENING QUESTIONNAIRE Appendix D: PRE-DEPLOYMENT HEALTH ASSESSMENT QUESTIONNAIRE Appendix E: POST-DEPLOYMENT HEALTH ASSESSMENT QUESTIONNAIRE Appendix F: POST-DEPLOYMENT HEALTH RE-ASSESSMENT QUESTIONNAIRE Appendix G: PROGRAM REVIEWS FROM *SUBSTANCE USE DISORDERS IN THE U.S. ARMED FORCES* Appendix H: TABLE OF DOD PROGRAMS TO INCREASE RESILIENCE OR PREVENT PSYCHOLOGICAL HEALTH DISORDERS, AS IDENTIFIED BY RAND