The Fund supports several networks of state health policymakers to help identify, inspire, and inform policy leaders.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
The Fund identifies and shares policy ideas and analysis on topics important to state health policymakers, particularly on issues related to state leadership, primary care, aging, and health care costs.
Keep up with news and updates from the Milbank Memorial Fund. And read the latest blogs from our thought leaders, including Fund President Christopher F. Koller.
The Fund publishes The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to health policy leaders.
The Milbank Memorial Fund is is a nonpartisan foundation focused on improving the health of communities and entire populations.
July 30, 2020
Primary Care Transformation Primary Care Investment
Katherine Grace Carman
Rachel O. Reid
Cheryl L. Damberg
May 12, 2022
Mar 2, 2022
Jan 24, 2022
Back to Publications
As the country struggles with its response to COVID-19, the health and future of primary care is a growing concern. In its research and convening, the Milbank Memorial Fund has encouraged the use of primary care spending measures to monitor the “primary care orientation” of states, payers, and health systems, compare payer performance, and establish accountability.
Many payers investing in primary care innovation are using alternative payment models (APMs), such as capitation payments, which are not captured through health provider claims. Previous research showed that payers did not routinely collect or analyze these data. To fill this gap, the Milbank Memorial Fund and the California Health Care Foundation commissioned RAND to review how leading states and payers are collecting APM data on primary care and make recommendations to standardize the information gathering and reporting process.
The RAND report, Advancing the Development of a Framework to Capture Non–Fee-For-Service Health Care Spending for Primary Care, identifies four key policy decisions that need to be addressed in order to standardize reporting:
“Primary care is among the highest value care in our delivery system, and it’s crucial that policymakers understand how much we’re spending on it,” says Kristof Stremikis, director of market analysis and insight at the California Health Care Foundation, which also supported the research. “This paper helps ensure we’re all measuring primary care spending in the same way.”
Additional work will be needed to finalize the standards. “We hope these recommendations will spur further national policy discussion and help guide how states and payers operationalize information about these non–fee-for-service payments,” says Rachel Block, program officer at the Milbank Memorial Fund. “The Fund will continue to encourage this work at the state level, and we will also promote further refinement of specifications and standardized reporting on the various types of APMs.”
Read the report
Get the Latest from the Milbank Memorial Fund
An endowed operating foundation that engages in nonpartisan analysis, collaboration, and communication, with an emphasis on state health policy.