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.
March 12, 2024
Policy Report
Howard Haft
Craig Jones
Publication
Jul 13, 2026
Apr 14, 2026
Feb 12, 2026
As part of the movement to improve population health through investments in primary care, more than 20 states are measuring the percentage of overall health care expenditures on primary care.1 The United States has over 10 years of experience with multipayer primary care models conducted in collaboration with the Center for Medicare and Medicaid Innovation (CMMI) that have helped to lay a foundation of advanced primary care. The energy around primary care investment targets, the impact of those investments, and lessons learned from CMMI’s multipayer advanced primary care programs now present an opportunity for reflection on the role of states in advancing primary care.
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. Acknowledging that individual states will follow many different paths, this discussion is meant to be categorical rather than prescriptive. We hope that lessons learned from these state-led journeys can inform and assist other states working with Medicare and Medicaid to move toward increasing their own investments in advanced primary care.
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