On July 29, the Primary Care Collaborative (PCC) hosted a webinar exploring how the Proposed 2027 Part B Payment Rule will affect primary care—and how CMS can continue to build on its momentum in strengthening primary care.
Moderated by Ann Greiner (PCC), the webinar featured a conversation with Dr. Jake Quinton (Center for Medicare) followed by a reaction panel with Stephanie Quinn (American Academy of Family Physicians), Dr. Nima Sheth (National Partnership for Women & Families) and Aisha Pittman (National Association of Affordable Care Organizations).
Dr. Quinton began by outlining how CMS hoped this year’s proposed rule would build upon improvements to primary care from 2026’s MPFS rule. Major initiatives touted by Quinton included:
- Converting the existing G2211 from an add-on code to a modifier
- Providing an additional bump in compensation for G2211 for ACOs, given the different resource costs necessary to deliver primary care in an ACO
- Exploring ways to roll out prospective payments in the Medicare Shared Savings Program (MSSP) by issuing an RFI
- And introducing efforts to reduce cost-sharing first tested in ACO Reach into the broader MSSP
Quinton framed the changes as part of a broader strategy to better align health care spending and value in the context of payment distortions and mispricing that that currently exists in the fee schedule. But now, according to Quinton, CMS is “embarking on a two-year strategy to change that.”
He also discussed the importance of “de-burdening” primary care, simplifying the process to start and participate in an ACO and make quality measurement less of a cumbersome hill to climb.
The conversation then shifted toward the continuity of primary care, particularly the importance of Advanced Primary Care Management (APCM) services. While there were no specific APCM proposals in this year’s proposed MPFS, Quinton believes CMS’s work on ACO policy will act as a pathway toward this reform. Acknowledging cost-sharing is a factor in APCM’s uptake, Quinton expressed hope that future CMS work could address the issue, particularly in ACOs.
Greiner unpacked this a bit further. With primary care being the front door of America’s health care system, cost-sharing acts as a powerful financial barrier that prevents people from accessing this critical care. She told Quinton that she hopes CMS continues exploring this and finding ways to reduce cost-sharing in primary care.
Quinton also dug into the expansion related to behavioral health services in the proposal. He argues that in order to improve the health of all Americans, the evidence shows that aggressive funding in this realm is a must. Also, with many new codes related to tobacco cessation and addiction services, CMS is also looking toward improving lifestyle medicine.
The discussion then shifted toward the use of virtual/digital tools in primary care. Through tools like ambient scribing, clinicians can greatly reduce the administrative burden they face. In the patient realm, many now use tools like ChatGPT as a sort of first step before visiting a primary care clinician. Quinton does not believe AI will replace primary care clinicians, but pondered its ability to expand the availability of evidence-based health information to patients. Greiner agreed, also highlighting that the evidence shows that the relationship between a primary care clinician and their patient is critical toward achieving better outcomes.
Following the fireside chat, Greiner then introduced a virtual panel of health policy experts to gather their reactions to the fireside chat.
Sheth kicked off the conversation by applauding CMS’s acknowledgement that comprehensive whole-person care must include behavioral health. According to Sheth, the proposed collaborative care reimbursement increases recognize the impact behavioral health has on healthy aging, functional status, menopause, quality of life, caregiving and more.
Pittman discussed NAACOS’ call for the Administration to modernize ACOs in three buckets of sustainability: burden, reduction and innovation. In terms of sustainability, she praised shared savings as a successful means to increase primary care investment. However, ACOs face a benchmarking problem. ACOs with a long tenure in MSSP compete against their own success, and the benchmark ratchet reduces the ability to earn shared savings. CMS has taken a few steps, but she encouraged further work on this.
Quinn stressed the importance of fostering deep patient-clinician human relationships. Health is beyond a “collection of codes,” and the longitudinal relationship really acts as the true power of primary care. She hopes that as AI expands, it evolves into something that could facilitate and empower that relationship rather than become just another level of discrete services and create more fragmentation.
Sheth then steered the conversation toward payment models. Even with a goal of designing payment systems around achievable positive outcomes, there’s still the question of how clinicians can ensure that that infrastructure is in place to hold the system accountable for delivering them. CMS is taking important steps forward in rebalancing payment towards primary care, she argues, but there’s still far more to do.
Sheth then outlined the unfortunate limitations that many clinicians face in implementing team-based care through community health workers, care coordinators, peer support specialists and more. Beyond payment, clinicians face workflow and trust issues. Pittman echoed this sentiment in the ACO realm.
Quinn then briefly turned the conversation toward primary care investment in Congress. As primary care faces passive devaluation over time, the introduction of the bipartisan Patients First Act is very promising. According to Quinn, keeping up with inflation in primary care pay and addressing structural payment levers in the fee schedule are critical toward improving access to comprehensive, whole-person primary care for patients.
Greiner concluded the conversation by asking viewers to share this webinar with colleagues who could not attend. The PCC would also like to invite viewers to attend our 20th Birthday Celebration at the 2026 Fall Forum and have their organizations consider sponsorship. This event will bring together PCC founders, board, members, partner organizations, policymakers, thought leaders and others in the primary care community to celebrate two decades of impact and explore primary care’s future.