Amidst a Tough Season for Primary Care, There Could Be Better Weather Ahead

This winter has been hard for primary care practices - and for the health of their patients. 

 A confluence of flu, RSV, and resurgent COVID challenged a primary care platform already weathering nearly three years of COVID and mental health challenges.  

Unfortunately, primary care’s situation today is no accident of nature; decades of policy choices have left many practices, particularly those in underserved communities, in fee-based reimbursement systems that do not adequately recognize their contributions. No matter the community we live in, this systematic underinvestment in primary care undermines our shared goal of better health. Congress’ year-end omnibus legislation, with its Medicare fee cut and phase-down of value-based care incentives, added insult to injury.  These retrenchments were balanced in part by helpful telehealth, mental health, children, and maternal health provisions. 

Yet in this New Year, there are signs of optimism with at least some policymakers having heard PCC's message: this nation’s health depends on changing how and how much we invest in primary care: 

1. Education and Training: With the first 200 additional medical residency slots funded by Medicare since 1996, the Department of Health and Human Services allocated nearly three out of four to primary care including obstetrics/gynecology as well as psychiatry. This follows $13 million in HRSA nursing workforce investments last year. 

2. Medicaid: The Center for Medicaid and CHIP Services will now provide federal matching dollars if state Medicaid programs reimburse for interprofessional consultation and initiatives to address unmet, health-related social needs – important steps to serving complex Medicaid populations in the primary care setting 

3. MedPAC: Congress’ designated advisors for Medicare payment voted to recommend a new bonus for safety net practices: 15% for primary care compared to 5% for other specialties 

4. State Capitols: Just a few days into 2023’s state legislative sessions, PCC’s brand-new State Primary Care Investment Hub already shows Massachusetts, Minnesota, Nevada, and Oklahoma legislators introducing bills to measure and/or strengthen primary care investment – joining 19 states that have already taken steps to do so. 

Could these rays of winter sunshine portend a broader break in the weather for federal primary care policy?  We await with anticipation the expected HHS Action Plan to Strengthen Primary Health Care and this year’s Medicare and Medicaid rulemaking to show that policymakers are taking significant steps to strengthen the primary care platform as a key lever to improve the health of the nation. In the meantime, PCC’s Better Health – NOW Campaign will keep insisting federal policymakers chart a bolder course in primary care – one that delivers better health for all our families and communities. If your organization is not yet involved, contact Larry McNeely at lmcneely@thepcc.org.