This series of profiles highlights five states that are in different stages of enacting and implementing primary care spending targets, including early planning and coalition building; active efforts to engage state policymakers; and implementation or revision of an enacted state policy. More

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 Agency for Healthcare Quality and Research (AHRQ) has released applications for funding up to 15 state-based health extension cooperatives, a key component of AHRQ’s newly launched Healthcare Extension Service.  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

“If this is love I want my money back” – Hot Tuna  This sentiment may well capture the mood in US primary care today. The 2021 National Academies of Sciences, Engineering, and Medicine (NASEM) report on primary care described the urgent need to adopt an updated vision and roadmap to improve primary care in the […] More

States should consider six key activities to prioritize resources and use their authority most effectively. More

This brief provides seven recommendations for how the federal government can support states in their primary care reform efforts. More

In an April 15, 2024, Opinion in Healthcare Dive, Christopher Koller, president of the Milbank Memorial Fund; Kyu Rhee, president and CEO of the National Association of Community Health Centers; and R. Shawn Martin, executive vice president and CEO of the American Academy of Family Physicians, explain that chronic disinvestment and inadequate training have created a shortage of primary care workers. More

Ed McGookin had a big problem.  Coastal Medical, the 150-physician medical group in Rhode Island that he leads, was facing more competition for a smaller pool of primary care physicians finishing their residencies in 2022. Now it was losing four physicians to early retirement in December of that year. He had to find new medical […] More