Making the Case for Policies that Support Growth of High-Performing Primary Care

Ann Greiner gave a presentation in Tampa, Florida on primary care investment, highlighting successes from key states. The presentation made clear that there is a fundamental disconnect between the importance of primary care to our healthcare system and the value we attribute to it. The U.S. only spends about 5-7% of their healthcare budget on primary care services, and this spending is declining. This lack of investment is especially jarring compared to primary care spending across the European Union, which averages 12%. Therefore, PCPCC’s goal is to increase primary care investment through alternative payment models, including the patient-centered medical home.

PCPCC’s recommendations for increasing primary care investment include defining standardized measures, engaging broad stakeholders, setting clear goals to achieve the quadruple aim, aligning payment models and utilizing incentives, and evaluating outcomes through evidence-based assessment. Several key states that are successfully increasing investment in primary care were highlighted, including Rhode Island—which increased primary care spending from 5.7% to 9.1% over four years while reducing costs by 14%—and Oregon—which legislatively mandated 12% spending on primary care in 2017.  Several other states have enacted or proposed similar legislation. Next steps include baseline and ongoing measurement, raising visibility of the issue, defining multi-stakeholder leadership, and evidence dissemination.