Primary Care Transformation

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

This report describes the experiences of states that have designed and implemented policies to pursue these multiple targets and gathers lessons from their experiences to inform future policy development. Interviews with state officials and a multi-state convening revealed the strategies states used to establish their targets and their experiences implementing them. Officials described challenges to implementation and efforts to overcome them. More

The authors offer guidelines on designing successful value-based payment contracts for FQHCs and recommend action steps for CMS, state Medicaid agencies, and FQHCs that will enable more of these safety-net providers to participate in value-based care — and realize savings as well as improved quality for patients. More