This 2022 California Health and Human Services Budget bill established the California Office of Health Care Affordability, required ongoing reporting, and established a process to set targets for primary care spend in the state.

Establishes an Office of Health Care Strategy Office to develop an annual health care cost growth benchmark and primary care spending target. Develops and adopts health care quality benchmarks. Develops strategies, in consultation with stakeholders, to meet such benchmarks and targets developed. Enhances the transparency of provider entities. Monitors the development of accountable care organizations and  patient-centered medical homes in the state. Monitors the adoption of alternative payment methodologies in the state. Legislation enacted as a provision of 2022 state budget legislation.

This Act expands the membership of the Primary Care Reform Collaborative and creates an Office of Value-Based Health Care Delivery in the Department of Insurance to reduce health care costs by increasing the availability of high quality, cost-efficient health insurance products that have stable, predictable, and affordable rates. The Office of Value-Based Health Care Delivery will work with the Primary Care Reform Collaborative and the State benchmarking process.

Defines primary care and details how primary care spending report will transpire in Maine moving forward. 

Requiring the Maryland Health Care Commission to provide a report, beginning December 1, 2024, and each year thereafter, to the Governor and the General Assembly containing an analysis of primary care investment, ways to improve the quality of and access to primary care services, and any findings and recommendations; requiring the Commission to establish a workgroup to develop the report to include an interpretation of the results of the required analysis and to make recommendations; etc.

This omnibus appropriations legislation would require a report on primary care spending and establish a Health Care Affordability Board that may consider establishing quality and primary care spending standards.

This legislation included a provision requiring an annual report on trends and drivers in spending in the health insurance market.  Subsequent reports have included information on primary care spend as a portion of overall spend.

The bill establishes the New Mexico Health Care Authority in July 2024. Also amends the Primary Care Council's duties to:
- Analyze the proportion of health care delivery expenditures allocated to primary care statewide annually.
- Develop a five-year plan to determine how primary care investment could increase access to primary care and improve the quality of primary care services while also lowering the costs of primary care delivery.
- Review national and state models of optimal primary care investment to increase access to and improve the quality of primary care services. 

Charges the North Carolina Primary Care Payment Reform Task Force with developing a definition of primary care that is applicable to the NC Medicaid program and commercial insurance, measuring how much insurance plans spend on primary care, determining the quality of the primary care delivery system in North Carolina, studying the primary care payment landscape in states that implement a minimum primary care spend, and collecting data to inform a primary care investment target for insurance plans.

SB 563 affirmed requirements for reporting of the percentage of health care expenses by each contracted entity on primary care services and that no later than the fourth year of a contract with the Medicaid program must devote at least 11% to primary care.

Requires coordinated care organization, Public Employees' Benefit Board and Oregon Educators Benefit Board to spend at least 12 percent of total medical expenditures on primary care by January 1, 2023. Requires Department of Consumer and Business Services to establish requirements for carrier to submit plan for increasing spending on primary care as percentage of total medical expenditures if carrier is spending less than 12 percent of total medical expenditures. Extends sunset on Primary Care Transformation Initiative.

The bill modifies and repeals reporting provisions related to the Department of Health and Human Services. Specifically, it repeals the requirement to publish annually a report on primary care spending within Utah.

This legislation directed.the Green Mountain Care Board and Department of Vermont Health Access to identify which health care providers and services constitute primary care, determine the percentage of health care spending currently allocated to primary care by certain public and private payers and by Vermont’s health care system overall, and report the percentages and related information to the General Assembly.

This bill required the state Department of Health and Human Resources to contract with the Virginia Center for Health Innovation for actions necessary to facilitate and continue the work of the Virginia Task Force on Primary Care. The purpose of the task force is to enhance the financing, quality and delivery of primary care in the Commonwealth.

Charges the state’s Health Care Cost Transparency Board with measuring and reporting on primary care expenditures and progress toward increasing spending to 12% of total healthcare expenditures.

Establishes the Office of Health Care Affordability (office) within the Office of Statewide Health Planning and Development (OSHPD). The office shall measure and promote a sustained systemwide investment in primary care and behavioral health. In furtherance of this goal, the office shall measure the percentage of total healthcare expenditures allocated to primary care and behavioral health and set spending benchmarks. Spending benchmarks for primary care shall consider current and historic underfunding of primary care services.. Establishes, within the office, the Health Care Affordability Advisory Board (board) and sets forth the composition and duties of the board, as defined, which includes "Measure and promote sustained systemwide investment in primary care and behavioral health". The office will also begin tracking the percentage of healthcare expenditures allocated to primary and behavioral healthcare. It will also help clarify and define what professionals are considered primary care. A version of this legislation was enacted as part of the 2022 budget.

This omnibus appropriations legislation would require the Commissioner of Health to provide a one-time report on primary care spending and establish a Health Care Affordability Commission with broader responsibility to establish broader health spending and outcome targets for the state.

Elements of this bill were incorporated in the final budget bill,SF 2995.

S. 750 would establish a multistakeholder Primary Care Board with a goal of increasing primary care spend to 12-15% of overall health care expenditures. The bill would also require all insurers in the state to offer a prospective, per member per month Primary Care 4 You payment to all primary care practices.  The payment would be adjusted for clinical and social risk and practice capacity. Monthly prospective payments would be paid from a Primary Care Trust, rather than individual plans.

Establishes the primary care reform commission to review, examine, and make findings on the level of primary care spending by all payers in the context of all health care spending in the state and publish an annual report on the findings, and also make recommendations to increase and strengthen spending on primary care in the state and improve primary care infrastructure, taking care to avoid increasing costs to patients or the total cost of health care.

Establishes the Primary Care Investment Task Force which will take a detailed and objective look at where Pennsylvania stands when it comes to primary care investments compared to other states. Building off their findings, the task force will also identify what can be done to bolster investment in primary care.

This Act expands the membership of the Primary Care Reform Collaborative and creates an Office of Value-Based Health Care Delivery in the Department of Insurance to reduce health care costs by increasing the availability of high quality, cost-efficient health insurance products that have stable, predictable, and affordable rates. The Office of Value-Based Health Care Delivery will work with the Primary Care Reform Collaborative and the State benchmarking process.

For the 3-year period ending with calendar year 2024, the aggregate primary care expenditure target for each of the 3 years shall be equal to a 30 per cent increase above aggregate primary care baseline expenditures, and the primary care expenditure target for each of the 3 years shall be equal to a 30 per cent increase above primary care baseline expenditures.

establishing the Health Care Affordability Board and Health Care Affordability Advisory Council; requiring monitoring of and recommendations related to health care market trends; establishing the health care spending growth target program; requiring reports; providing for civil penalties; requiring certain transfers of funds;

Primary care spending would be subject to measurement, analysis and annual reporting under this broader legislation establishing health care spending growth benchmarks for the state.

This bill proposes to require health insurers, the State Employees’ Health Benefit Plan, and the health plans offered to school employees to increase the percentage of total health care spending they allocate to primary care to at least 15 percent and would require the next all-payer model agreement with the federal government to include a provision requiring annual increases in primary care spending in Medicare.

Requires commercial plans covering 500 or more lives, the State Employees Benefit plan and the Green Mountain Care Board to increase the proportion of health care spending allocated to primary care by 1% a year until reaching 12%.