Primary Care Investment

To inform state-level primary care payment policies, we reviewed recent policies advancing primary care payment reform in the commercial sector and conducted interviews with 50 stakeholders in five pioneering states: Arkansas, Colorado, Delaware, Rhode Island, and Washington. More

Primary care clinicians are a bellwether for the state of health care and health in the United States. With the Trump Administration moving at… More

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

“Chris, if you have a hammer, everything looks like nail.”  So said the general surgeon in the HMO where I was working 30 years ago, as… More