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  • A Real Gully Washer

    A Real Gully Washer

    February 2025 Christopher F. Koller, 

    The new federal administration is implementing its strategy of, as one if its puppet masters, Steve Bannon, likes to say, “flooding the zone.” Over the course of three weeks, it has released over 50 executive orders and taken administrative actions designed to abolish agencies, flush out a swath of the government workforce, and test the constitutional balance of powers. Collectively this is a real gully washer of executive branch activity. The state and local health officials that Milbank supports are leaders in the communities at the mouth of the gully who are dealing with all that is washing out to them. More

  • 2025 Primary Care Scorecard Dashboard

    2025 Primary Care Scorecard Dashboard

    February 2025

    Informed by the National Academies of Science Engineering and Medicine (NASEM) 2021 report on primary care and an advisory committee of key… More

  • V. Research: The lack of research dollars to study the practice of primary care is limiting evidence-based improvements in care

    Report

    V. Research: The lack of research dollars to study the practice of primary care is limiting evidence-based improvements in care

    February 2025

    Despite the dire picture much of these data paint for the state of primary care, there are bright spots where primary care is flourishing. Yet more… More

  • IV. Technology: The lack of investment in EHRs has led to burdensome systems that drain clinicians’ time, thereby reducing patient access to care

    Report

    IV. Technology: The lack of investment in EHRs has led to burdensome systems that drain clinicians’ time, thereby reducing patient access to care

    February 2025

    EHRs, as currently designed and implemented, continue to be a burden for primary care practices Primary care clinicians spend more time on… More

  • III. Training: Misdirected graduate medical education funding is failing to produce new primary care physicians, exacerbating patient access issues

    Report

    III. Training: Misdirected graduate medical education funding is failing to produce new primary care physicians, exacerbating patient access issues

    February 2025

    Financially strained primary care practices discourage students from choosing primary care careers Rebuilding the primary care workforce will… More

  • II. Workforce/Access: Insufficient funding is diminishing the primary care workforce and access to care

    Report

    II. Workforce/Access: Insufficient funding is diminishing the primary care workforce and access to care

    February 2025

    Underinvestment and fee-for-service payment leads to practice inefficiencies and decreased capacity The ongoing lack of investment in primary… More

  • I. Financing: Declining investment and fee-for-service payment are hindering primary care clinicians’ ability to meet growing patient needs

    Report

    I. Financing: Declining investment and fee-for-service payment are hindering primary care clinicians’ ability to meet growing patient needs

    February 2025

    Primary care is the foundation of any health care system that delivers timely, high-quality, and equitable care. Yet, in the United States, we have… More

  • The Health of US Primary Care: 2025 Scorecard Report — The Cost of Neglect

    Report Health of US Primary Care Scorecard Primary Care Transformation

    The Health of US Primary Care: 2025 Scorecard Report — The Cost of Neglect

    February 2025 Yalda Jabbarpour,  Anuradha Jetty,  Hoon Byun,  Anam Siddiqi,  Jeongyoung Park, 

    This 2025 Primary Care Scorecard spotlights the downward cycle of financing for primary care, describing how persistent challenges in primary care arise from insufficient investment (or in the case of training, misplaced investment) and a fee-for-service (FFS) payment model that rewards volume rather than continuous, whole-person care. This report highlights how these systemic financial issues not only undermine the effectiveness of primary care delivery but, more importantly, jeopardize the overall health of our communities in the following ways. More

  • Lessons Learned from State Efforts to Slow and Shift Health Care Spending

    Report Primary Care Transformation Sustainable Health Care Costs

    Lessons Learned from State Efforts to Slow and Shift Health Care Spending

    February 2025 Robert Seifert,  Emma Rourke,  Mary Jo Condon, 

    Abstract State governments have created a pathway to improve health care affordability by setting targets (or benchmarks) for annual cost growth.… More

  • Embargoed Until 2/18: 2025 Primary Care Scorecard Data Dashboard

    Informed by the National Academies of Science Engineering and Medicine (NASEM) 2021 report on primary care and an advisory committee of key… More