In many cases “primary care investment” has been too narrowly defined as higher annual operating payments. According to a recent article in JAMA, spending increases alone are unlikely to address persistent access gaps and poor U.S. outcomes relative to peer countries. Accordingly, the author proposes a state-led capital investment strategy to build durable primary care workforce capacity, alongside payment reform and productivity tools such as interoperability and AI. Based on HRSA projections of a primary care physician shortfall of 87,150 by the mid-2030s just to keep pace with current levels of care, the article estimates that the training and pipeline resources required to materially expand primary care could reach $100 billion. States that want to materially improve primary care coverage will need to spend significantly more on facilities, IT infrastructure and working capital. The author outlines a three-part investment strategy to do so. from Rethinking Primary Care Investment Strategy
While high-quality primary care is the foundation of an effective health system, simply setting an ambitious primary care spending target does not guarantee better care, access, or equity. In recent years, some states have announced plans to increase or even “double” primary care spending as a share of total health expenditures. Yet only a small number have authorized, enforceable targets, and only two have actually reached them so far. Mr. Wadsworth conceived of the Nine Key Levers as a framework for implementation, a basis for evaluating existing state primary care plans, or an instructional resource. We have published, or plan to publish, the following articles:
State Primary Care Funding Strategy: Key Lever 1 – Authorizations, Goals & Objectives: from Spending Targets to Plans (6/23/2026)
The State Primary Care Spending Paradox: broadest definition vs most ambitious spending target (6/3/2026)
Key Lever 2 – Primary Care Needs Assessment (5/20/2026)
Key Lever 6 – Infrastructure Development & Investment: Building State Primary Care Capacity (7/22/2026)
State Primary Care Funding Strategy: An Infrastructure Investment Fund (7/15/2026)
Key Lever 7 – Provider Reimbursement [to come]
Key Lever 8 – Data Measurement & Reporting [to come]
Key Lever 9 – Continuous Quality Improvement [to come]
PrimaryCareInvestment #StateHealthPolicy #HealthcarePolicy #HealthcareGovernance #PrimaryCareTransformation #PrimaryCareWorkforce #KeyLevers