Primary Care Network Archive

The Milbank Memorial Fund supported two now-archived primary care networks: the Multipayer Primary Care Network and the Medicaid Transformation Network.

For over a decade, the Multipayer Primary Care (MPC) Network provided a forum for members involved in multipayer primary care transformation to share data, participate in collaborative learning, and advocate for improved collaboration between the states and the federal government on new and ongoing initiatives. Payers in 30 states or regions were represented at various times, with a maximum 150 participants (~60 active).  The MPC was disbanded in February 2024. Given the dwindling number of participants due to lower payer involvement in CMMI Primary Care models and our sharper focus on historically marginalized and underserved populations, this decision was consistent with the Fund’s new focus on health equity.

The MPC supported the following Center for Medicare and Medicaid Innovation Center (CMMI) primary care models:

  • Multipayer Advanced Primary Care Practice Demonstration (2011-2016)
  • Comprehensive Primary Care Initiative (2012-2016)
  • Comprehensive Primary Care Plus (2017-2022)
  • Primary Care First (2020-present)

The Medicaid Transformation Network was a voluntary collaborative of State Medicaid Agencies actively engaged in multipayer efforts to create and sustain high-quality primary care for their citizens.  It focused on multipayer value-based payment and on measuring progress towards health equity goals.

The participating states included Arkansas, Connecticut, Maryland, North Carolina, Oregon, Virginia, Vermont and Washington, represented by approximately 20 State Medicaid Agency leaders.

The network was disbanded in December 2023, when the Milbank Making Care Primary (MCP) Network was established at the request of CMMI leadership.

Primary Care Networks

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Publication

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

February 2025
Yalda Jabbarpour, Anuradha Jetty, Hoon Byun, Anam Siddiqi and 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

Publication

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

February 2025
Robert Seifert, Emma Rourke and Mary Jo Condon
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

Blog Post

Health Extension Cooperatives: Three States Show the Way

October 2024
Art Kaufman, Craig Jones and Howard Haft
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

Publication

Supporting Federally Qualified Health Center Participation in Value-Based Payment to Improve Quality and Achieve Savings

September 2024
Aditya Mahalingam-Dhingra, Vikki Wachino and Kim Prendergast
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

Blog Post

Primary Care in the Crosshairs of Market Structure Changes

June 2024
Rachel Block
“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

Publication

Defining the State Role in Primary Care Reform

May 2024
Lauryn Walker, Lisa Dulsky Watkins and Christopher F. Koller
States should consider six key activities to prioritize resources and use their authority most effectively. More

Publication

It Takes Two to Tango: Creating an Effective State–Federal Partnership for Primary Care Reform

May 2024
Lauryn Walker, Shannon Dowler, Barbra Rabson and Bob Rauner
This brief provides seven recommendations for how the federal government can support states in their primary care reform efforts. More

News Article

No appointments available: America’s escalating primary care shortage

April 2024
Christopher F. Koller
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

Blog Post

Improving Primary Care Access When You Can’t Wait for Policy Change

March 2024
Christopher F. Koller
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

Publication

Considerations for Statewide Advanced Primary Care Programs

March 2024
Howard Haft and Craig Jones
In this report, we share insights gained from our experience working with CMMI on innovative state-led primary care programs in Vermont and Maryland, presenting key elements of approaches to invest new primary care dollars. More