Over the last several years, headlines have touted that multiple states are doubling their primary care spending as a percentage of total health expenditures. But only five states[1] have formal, enforceable primary care spending targets. And five additional states participating in CMS’s AHEAD program have committed to increasing primary care spending as a share of total health care costs. Finally, Massachusetts is now considering legislation that would more than double its measured primary care spending. Closer examination reveals that some of these spending targets are really quite modest and only two states have reached their targets.
“High-quality primary care is the foundation of the health care system. Without access to high-quality primary care, minor health problems can spiral into serious illness, chronic diseases go unmanaged, and the opportunity to prevent illness is lost.” Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care, National Academies of Sciences, Engineering, and Medicine, 2021
But a spending target is not a strategy. Without clear goals and objectives, attempting to redirect dollars toward primary care may simply result in higher total health care spending. The purpose of this article is to explain Authorizations, Goals & Objectives, the first of the Nine Key Levers shown in the graphic above. While a spending target can create financial opportunity, authorizations, goals, and objectives determine whether that opportunity becomes a well-organized, accountable plan for better and more cost-effective healthcare delivery.
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