The Health Care Cost Institute (HCCI) released its analysis of 2016 health spending for a group of commercial insurers last month. The report is a trove of information that, like all good analyses, suggests more questions than it answers. Buried in the report—in figure 15—is an alarming trend that should rise to the top of analysts’ areas for further investigation. How can it be that during an era of increasing focus on health care value, the portion of health spending going to primary care actually went down?