Pay for What Patients Want: Primary Care for the Whole Person 


If you or someone you love depends on Medicare, you know managing that person’s health isn’t easy. Even on a good day, you may find yourself navigating multiple chronic health needs while simultaneously addressing the mental, behavioral and cognitive health conditions.  

If that’s your situation, continuous, whole person primary care - where a trusted clinician actually listens to you, gets to know you and ensures your goals and needs don’t get lost in our complicated healthcare system – can be a game changer.  If there was any doubt of that, research over the years continues to show that improved continuity in primary care reduces mortality while constraining health care expenditures and hospitalizations.  

Unfortunately, the way Medicare pays for health care tends to reward tests and procedures…but starves this kind of personalized primary care of the support it needs.   (That’s one reason why we see so many ads for the hospital’s latest surgical wing on billboards, but finding a timely primary care appointment keeps getting harder.) 

In two Presidential administrations – Republican and Democratic – Medicare officials have proposed that Medicare actually cover and pay for this kind of continuous, inherently complex care. (Medicare even gave the service a billing code: G2211.) After one Congressionally-mandated delay, that long-needed policy is now proposed to go into effect on January 1st, 2024.  

But some on Capitol Hill, at the urging of the same specialty lobbies who win out under today’s payment system, may be tempted to roll back Medicare’s proposal yet again. 

When much of health care quickly shuffles people through the doors, covering and paying for complex care could drive more resources to your trusted source for primary care. That support, in turn, can help your primary care practice do a better job of delivering all that goes into high-quality, whole person care…helping them dedicate the time needed to fully understand your health needs and build the primary care teams needed to address those needs. 

Paying for continuous, complex care over time is important but not a panacea. PCC’s Better Health – NOW Campaign has called for bolder and broader changes to how and how much we pay for primary care. But investing more now in complex care for people on Medicare is a critical down payment. 

At a time when the U.S. health system is weathering a primary care workforce crisis, another delay in in the G2211 policy and the complex care it supports would be an unacceptable step backwards.  

In our comments on this year’s annual Part B Medicare payment rule, PCC expects to praise Medicare officials for standing strong against political pressure.  Now Members of Congress have to follow their example.  




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