As a former pediatrician in rural Vermont and a career-long believer in the centrality of primary care, I have been frustrated and dismayed to witness the lack of definitive evidence demonstrating what is considered to be conventional wisdom—that a high-performing health system must have primary care at its core. For a decade, I have been in the position of counseling patience, insisting that the upfront investment in the quality of, data for, and access to primary care will eventually pay off. I truly believe that, with adequate resources to provide care management and care coordination, primary care practitioners and their staff can keep people healthier. The good news is that the tide is finally turning.

Primary care practices in Ohio and Kentucky are starting to produce the results I hoped to see. As participants in the Comprehensive Primary Care (CPC) Initiative—the largest scale and longest-running primary care transformation experiment in the United States (see Figure 3)—the Greater Cincinnati/Dayton Metropolitan Statistical Area (OH/KY CPC region) was able to show that their efforts have made impressive impacts in most of the insured CPC populations in their geographic region.