The Fund supports networks of state health policy decision makers to help identify, inspire, and inform policy leaders.
A bipartisan group of state health policymakers from both the executive and legislative branches who are focused on improving population health.
Networks of state officials, advocates, and others aiming to invest in and transform primary care.
A program dedicated to advancing state-based efforts to make health care more affordable for residents, employers, and states.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
A leadership development program for early and mid-career state government officials who are committed to improving the health of all people in their communities.
A leadership program for senior state government officials who are committed to improving population health.
The Fund focuses on creating an affordable health care system built on strong primary care and partnerships that improve health outcomes for all.
Improving state leaders’ ability to enact and implement evidence-based health policies.
Advancing policies that create a more prevention- and primary care-oriented health system.
Improving population health through policies that contain health care cost growth.
Our state health policy resources offer relevant data analysis and best practices.
The Fund publishes reports, issues briefs, and case studies on state health policy issues.
Short takes on health policy issues from Milbank staff and guest authors.
Insights from Milbank President Debra Lubar on state health policymaking.
Reported articles and Q&As on timely health policy issues, as well as foundation updates.
Milbank Memorial Fund and Milbank Quarterly webinars featuring state health policymakers and researchers.
Updates and expert contact information for reporters.
The Milbank Memorial Fund is a private foundation that works to improve population health and health equity.
May 21, 2025
Policy Report
Hope Glassberg
Henry Chung
Jordanna Davis
Adam J. Falcone
Alison Gold
Publication
Jul 13, 2026
Apr 14, 2026
Feb 12, 2026
Primary care providers, especially those working within community health centers (CHCs), are pivotal in the shift from fee-for-service to value-based payment (VBP) for health care. VBP models, in turn, offer financial incentives like up-front care management payments or shared savings opportunities. However, successfully adopting VBP models demands new competencies and investments, a challenge made more acute for many CHCs, which face financial pressures as they strive to provide high-quality, accessible care to all. This report offers CHCs, their partners, policymakers, and others a place to start in addressing these challenges, particularly as the safety net faces potential cuts in federal funding for Medicaid. Drawing on interviews with experts and available literature, the authors organize the services and supports critical for VBP success into a practical framework consisting of four infrastructure domains: (1) leadership, governance, and legal; (2) operations; (3) data, analytics, and technology; and (4) financial. Each domain is explored in depth, with real-world examples and actionable recommendations to help CHCs prioritize investments tailored to their specific VBP opportunities. The report also offers considerations to help CHCs make informed, context-specific choices as they implement VBP models that optimize their resources and impact.
Back to Publications