Where Is the World Heading? Why Is Whole-Person Healthcare Now Essential?

CMS INNOVATION CENTER • 2024–2025 STRATEGY

A System That Prevents Disease Rather Than Waiting for It

The CMS Innovation Center (CMMI), the innovation laboratory of US Medicare/Medicaid, is preparing to integrate evidence-based preventive services directly into payment models.

• Nutrition, physical activity, sleep and stress management are becoming an official part of clinical outcomes.
• Regular participation in chronic disease programs creates, for patients and physicians alike, incentives .
• In kidney failure, the “Kidney Care Choices” model measures success by how long dialysis can be delayed .

WHOLE-PERSON CARE • CONCEPT

The Need to Consider the Whole Person

The new model assesses patients beyond diagnostic codes, considering biological, psychological, social and environmental factors together.

• The focus shifts from “which drug was prescribed?” to “how much did quality of life and function improve?” .
• Community programs and lifestyle change move to the center of treatment planning.

A 50-Billion-Dollar Rural Health Transformation

Healthcare access has long been a serious issue in rural America. Rural Health Transformation (RHT) is therefore attracting every state's attention with its 50-billion-dollar budget.

• Strengthen primary care infrastructure
• Expand the local healthcare workforce
• Bring services closer to homes and communities
• Extend lifestyle-based prevention to rural regions

Shared Principles 2025: A Common Language for Primary Care

The Primary Care Collaborative (PCC) published updated primary care principles with contributions from approximately 400 organizations, signaling a shared national vision.

Key terms include:

• Whole-person care and community engagement
• A focus on prevention and health promotion
• Protecting clinician well-being
• A patient-centered, transparent, outcome-focused approach

The Weakest Link: The Share Allocated to Primary Care

Of US healthcare expenditure, only 4.7% goes to primary care, substantially below the OECD average.

Greater transparency creates real momentum for national transformation; the decisive change, however, will come from steadily increasing this share .

Technology and Data: The Real Driver of the New Model

Electronic health records must become more than digital archives storing results: clinical decision-support engines .

• Physicians can receive immediate notification when their patients attend emergency care.
• For chronic conditions such as diabetes and hypertension, population-based dashboards can be viewed.
• Nutrition, activity and sleep data can be integrated into health records to generate AI-based risk scores .

As the USA begins discussing this transformation, Turkey has a more advantageous starting point in digital health infrastructure than might be expected (discussed below).

Multidisciplinary Primary Care

In the proposed model, primary care is designed as a place for conducting a multidisciplinary orchestra , rather than a physician working alone.

• Dietitian, psychologist, occupational therapist
• Pharmacist and social worker
• Home care and community support teams when needed

The message is clear: Chronic diseases can be managed through coordinated teamwork rather than a single specialty.

Without Payment Reform, Nothing Changes

The current “fee-for-service” model rewards the number of tests and procedures, making preventive services virtually invisible.

For whole-person care to become reality, teams that reduce hospital admissions and improve chronic disease control need financial support. All speakers agreed on this point.

1 • THE HEALTH CENTER ERA (1963–2000s)

A Region-Based, Holistic Model

Health centers established under Law No. 224 on the Socialization of Health Services brought population-based responsibility, preventive services and environmental health under one roof.

Many principles now described as “whole-person care” were already being applied in practice in that era.

2 • FAMILY MEDICINE (AFTER 2004)

Person-Centered Follow-Up and Registered Populations

The transition from health centers to Family Health Centers significantly improved population registration, performance monitoring and accessibility.

• A dramatic decline in infant mortality
• Nationwide coverage in antenatal follow-up
• Globally successful vaccination rates

3 • KETEM AND ORGANIZED SCREENING

Strong Infrastructure for Cancer Screening Programs

Cancer Early Diagnosis, Screening and Training Centers (KETEM) marked a major public health milestone, offering organized breast, colorectal and cervical cancer screening.

Many screening approaches newly being discussed in the USA have been implemented in Turkey as national programs for years .

Current Steps Aligned with Whole-Person Care

Recent Ministry of Health initiatives are repositioning primary care for behavior change and chronic disease management .

• Expanding nutrition, physical activity and mental health services through Healthy Life Centers
• Including socioeconomic determinants of health (SDOH) in national reports
• Diabetes schools, obesity centers, smoking cessation and mental health counseling units

A Strong Start in Digital Health: e-Nabız

Turkey's national e-Nabız system, integration of medicines, tests and imaging, and data flow between family physicians and hospitals have provided a unified health record infrastructure for years, which many countries are still trying to build.

This infrastructure provides a powerful foundation for AI-supported risk scores, incorporating behavioral data (activity, sleep, nutrition) into health records, and early warning systems .

CheckTheLife's desktop version and further information are available at checkthelife.app . This project can be viewed as a concrete Turkish digital health example of the whole-person care vision described in this article.