In the first year of the Rural Health Transformation Program (RHTP), states have homed in on a few core themes designed to improve the nation’s rural health infrastructure.
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Every other week, the Primary Care Collaborative (PCC) gathers major new stories, opinion pieces, research articles, case studies and more covering primary care. Want to submit a piece? Feel free to email the piece to PCC Communications Associate Maximilian Sandefer at msandefer@thepcc.org.
ABMS Announces 2026 Service Award Recipients
Susan Morris, American Board of Medical Specialties
The American Board of Medical Specialties announced its 2026 Service Award recipients, recognizing individuals who have advanced physician professionalism, quality improvement and certification. While not focused exclusively on primary care, the awards highlight leadership that contributes to improving health care quality across specialties.
Why Doctors Burn Out, Connecting With Patientsand How to Fix It
Kevin Pho, Eva Minkoff and Kim Downey, KevinMD
This podcast episode explores the drivers of physician burnout and the importance of rebuilding meaningful patient relationships. The discussion emphasizes that reducing administrative burden and restoring time for patient care are essential to sustaining the primary care workforce.
Primary Care Doctor Pay Hits $330,000, But Increase Lags U.S. Inflation
Bruce Japsen, Forbes
Primary care physician compensation continues to rise but has failed to keep pace with inflation. The article explores how financial pressures may affect physician recruitment, retention and the long-term sustainability of primary care practices.
Carey Goryl and Eli Greenspan, Medical Economics
Authors argue that expanding residency training positions is one of the most effective ways to address physician shortages. Increasing residency opportunities, particularly in primary care, could improve workforce capacity and patient access over time.
COMMENTARY – G2211: A Half-Step That Leaves Independent Primary Care Behind
Robert Resnik, Medical Economics
The author argues that while Medicare’s G2211 add-on payment recognizes the value of longitudinal primary care, it falls short of addressing the financial realities facing independent practices. Broader payment reform, the article contends, is needed to sustain comprehensive, relationship-based primary care.
Video Report, News Center Maine (via Yahoo! News)
Sen. Angus King introduced legislation aimed at making primary care and mental health services more available, emphasizing preventive care as a way to reduce costs. The proposal connects directly to primary care access by seeking to reduce financial barriers to routine and behavioral health care.
Rural physicians are leaving Medicare faster than anyone is tracking
Francesca Mathewes, Becker’s Hospital Review
An increasing number of physicians are opting out of Medicare, raising questions about beneficiary access to care and reimbursement policy. The trend also has implications for primary care, where Medicare participation is critical to maintaining access for older adults.
More Doctors Where They’re Needed: Reforming Medicare’s GME Formula
Lawson Mansell and David Schwartzman, Niskanen Center
This analysis argues that Medicare’s graduate medical education funding formula should be reformed to better align physician training with workforce needs. Redirecting GME resources toward primary care and underserved communities could help address persistent access shortages.
States Face Massive Medicaid Issues Thanks to the One Big Beautiful Bill Act
Eileen Appelbaum, CounterPunch
This commentary examines how recent federal Medicaid legislation could create new financial and operational challenges for states. The author argues that changes to Medicaid funding and eligibility could reduce access to primary care for millions of beneficiaries while increasing pressure on safety-net providers.
New Survey Finds Nearly Three-Quarters of Illinois Physicians Have Experienced Downcoding
Illinois State Medical Society, Small Business News Watch
A new survey reports that nearly three-quarters of Illinois physicians have experienced insurance downcoding, resulting in lower reimbursement than expected. Downcoding creates financial challenges for physician practices, particularly independent primary care practices operating on narrow margins.
The Case for Integrated Primary Care Across 10 Countries
Munira Z. Gunja, Arnav Shah, Corinne Lewis, Commonwealth Fund
A new Commonwealth Fund survey compares how ten countries integrate primary care with behavioral health, specialty care and community services. The findings suggest that stronger integration improves coordination, patient experience and overall health system performance.
Q&A: Why Providers Must Still Work to Reduce Care Fragmentation
Teta Alim, HealthTech Magazine
Health care leaders discuss how fragmented care continues to create inefficiencies and poorer patient outcomes despite advances in health technology. Strong primary care remains central to coordinating services across specialists, hospitals and community resources while delivering more whole-person care.
OPINION: Seat at the Table: Why Community Providers Need a Voice in Health Care Reform
Wendy Thompson, Chief Healthcare Executive
This viewpoint argues that meaningful health care reform must include the perspectives of community-based providers who understand patients’ day-to-day needs. The author emphasizes that strengthening primary care and community partnerships is essential to improving access, care coordination and health outcomes.
Katherine A. Gergen Barnett and Judith L. Steinberg, The Journal of the American Board of Family Medicine
This research article in the Journal of the American Board of Family Medicine examines an issue affecting family medicine and primary care practice. The findings contribute to the growing evidence base that informs clinical care, workforce planning and primary care policy.
Kathryn Palmer, Inside Higher Ed
Medical schools continue to expand in response to projected physician shortages across the country. While increasing enrollment is an important step, the article notes that expanding graduate medical education–particularly in primary care–is necessary to translate new graduates into practicing physicians.
Federal Push to Increase U.S. Primary Care Docs Has Fizzled, Study Says
Dennis Thompson, Health Day
A new study concludes that federal efforts to expand the primary care physician workforce have produced limited results. The findings highlight the need for sustained investments in medical education, residency training and payment reform to strengthen the primary care pipeline.
American Association of Nurse Practitioners, PR Newswire
A statewide survey found that Michigan residents are experiencing longer wait times for health care appointments and support expanding access to nurse practitioners. The findings illustrate how team-based primary care may help address growing demand and workforce shortages.
Massachusetts Senate passes bill to overhaul primary care
Jonathan Saltzman, Boston Globe
Massachusetts lawmakers have advanced legislation that would increase accountability for primary care investment and encourage insurers to devote a larger share of health care spending to primary care. Supporters argue the bill could improve access while helping shift the health care system toward prevention and value-based care.
Editorial: Bill Gives Primary Care the Overdue Attention It Deserves
Editorial, The Sun
This editorial applauds Massachusetts lawmakers for prioritizing primary care through legislation designed to increase investment and improve access. The piece argues that strengthening primary care is essential to improving health outcomes and controlling long-term health care costs.
Iowa Primary Care Association to Host Rural Health Care Sessions in Fairfield in July
AJ Roe, Ottumwa Radio Group
The Iowa Primary Care Association is hosting rural health care sessions in Fairfield to engage local communities on access and care delivery challenges. The effort highlights the role of primary care organizations in strengthening rural health infrastructure and supporting community-based solutions.
UM Launches Montana’s 1st Public PA Program Aimed at Tackling Rural Health Care Shortage
Missoulian Staff, The MSU Exponent
The University of Montana is launching the state’s first public physician associate program to address health care workforce shortages, especially in rural communities. By training more PAs, the program could help expand team-based primary care capacity in underserved parts of the state.
Oregon Health Director’s New York Times Essay Draws Response From State Primary Care Group
Andrew Schwartz, Willamette Week
Oregon’s primary care community responded to a New York Times essay by the state’s health director, raising concerns about how primary care is represented in broader reform debates. The article underscores the importance of including frontline primary care voices in conversations about cost, access and system redesign.
Legislature Passes Bill to Expand Roles for Nurse Practitioners
Alex Gault, Watertown Daily Times
New York lawmakers passed legislation expanding the role of nurse practitioners, a change aimed at improving access to care. For primary care, broader NP practice authority may help address provider shortages and improve access in underserved communities.
Arizona Must Protect Its Health Care Workforce
Keith Frey, Arizona Capitol Times
This commentary warns that Arizona’s health care workforce is not keeping pace with population growth, physician retirements and rising demand. It cites a need for hundreds more primary care physicians today and nearly 2,000 more by 2030, making workforce investment central to maintaining access.
Kansas Has More Rural Hospitals at Immediate Risk of Closing Than Any Other State
Ben Shackelford-Nwanganga, Rural Messenger
Kansas has more rural hospitals at immediate risk of closure than any other state, according to new national analyses. Because rural hospitals often anchor local primary care and referral networks, closures could significantly reduce access to preventive, chronic and emergency care for rural residents.
Primary Care Medics: Lessons From the Military Might Help Close Health Care Gaps in Rural PA
Whitney Downard, Penn Capital-Star
This article explores whether adapting military-style medic training could help expand access to basic health care services in rural Pennsylvania. The model offers one potential strategy for supporting primary care teams in communities facing persistent workforce shortages.
Figuring Out How to Expand Health Care Access in Pennsylvania’s Rural Communities
Whitney Downard, Penn Capital-Star
Pennsylvania leaders are exploring strategies to improve health care access in rural communities where provider shortages remain a significant challenge. The discussion highlights the importance of strengthening primary care infrastructure alongside broader rural health investments.
6th State [Alaska] Adopts Physician Associate Title
Paige Twenter, Becker’s Clinical Leadership
Another state, Alaska, has officially adopted the title ‘physician associate’ in place of ‘physician assistant,’ reflecting a broader national movement within the profession. The change is intended to better reflect the clinical responsibilities of PAs, who play an increasingly important role on primary care teams.
[Rhode Island] Legislators OK Bill to Disclose AI Use in Health Care Visits
Christopher Allen, Providence Business News
Rhode Island lawmakers approved legislation requiring patients to be notified when AI tools are used to document health care visits and requiring clinicians to review AI-generated documentation for accuracy. As AI tools expand in primary care, transparency and oversight will be important to preserve trust and protect the patient-clinician relationship.
Primary Care Meets Artificial Intelligence
Lambeth Hochwald, Medscape
This article explores how artificial intelligence is beginning to reshape primary care, from clinical documentation to workflow management and decision support. It emphasizes that successful adoption will depend on ensuring AI enhances–rather than replaces–the relationship between clinicians and patients.
As AI Listens to Patients, Physicians Face New Questions
Michael Waldholz, Medscape
This article examines the growing use of ambient AI tools that automatically document patient visits. While these technologies may reduce documentation burden in primary care, they also raise important questions about patient privacy, transparency and clinician oversight.
Mass General Brigham and CVS Primary Care Partnership Moves Closer to Reality
Marin Wolf, Boston Globe
Mass General Brigham and CVS are moving closer to a partnership involving primary care delivery. The proposal reflects broader market shifts in which health systems, retailers and insurers are exploring new models to expand access and coordinate care.
Most Clinicians Say U.S. Health Care Is Less Stable Than Two Years Ago
Austin Littrell, Medical Economics
A national survey found that most clinicians believe the U.S. health care system has become less stable over the past two years. Respondents cited financial pressures, staffing shortages and administrative burden, all of which continue to affect primary care practices and patient access.
This compilation was created with support from an AI tool.
The Iowa Primary Care Association will host two technical assistance sessions in Fairfield on Thursday, July 9th at the Fairfield Arts and Convention Center to help organizations prepare for upcoming state funding opportunities focused on improving access to coordinated care in rural communities, according to a press release from the organization.
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Comprehensive primary care promises to transform the U.S. health care system by unlocking powerful health improvements and cost savings for patients and taxpayers. By investing in primary care, lawmakers can improve the health and wellbeing of all Americans.
The package of fact sheets below examines the state of primary care in all 50 states and the District of Columbia.
Comprehensive primary care promises to transform the U.S. health care system by unlocking powerful health improvements and cost savings for patients and taxpayers. By investing in primary care, lawmakers can improve the health and wellbeing of all Americans.
The fact sheet below examines the state of primary care in Iowa.
A strong interest from states, combined with the flexibility of the Rural Health Transformation Program (RHTP), is highlighting a renewed commitment to primary care. Many governors and state lawmakers have agreed to allocate parts of their federal grant to strengthen primary care, and, in some instances, support efforts that existed before or are separate from RHTP.
The $50 billion RHTP allowed states broad latitude to design their plans, including goals that bolster primary care, such as expanding access, improving prevention and chronic disease management, workforce development and innovative care delivery.
Supporters have highlighted research showing that increased primary care investments lead to higher-quality care at lower costs. Higher investment in primary care is also associated with higher patient satisfaction, fewer hospitalizations and emergency department visits and lower mortality.
Some of the recent state examples include:
Iowa Governor Kim Reynolds in her Condition of the State Address said they are beginning to award contracts for life-saving treatment through their Healthy Hometowns initiative. She said, “Our Healthy Hometowns plan also supports communities in creating local care teams who together can provide primary care and chronic disease management for their patients and ideally locate all providers within one building.”
For instance, a patient with diabetes and heart disease could see a primary care provider for a routine visit, then meet with a dietician to create a personalized meal plan, discuss medications with a pharmacy tech and consult with a care navigator about health goals. Governor Reynolds said, “It would be transformational. And it’s all within reach — right now.”
Maryland Governor Wes Moore’s RHTP emphasized efforts to directly back advanced primary care practices and align rural funding with all-payer payment reforms that require primary care investment.
He also stressed that the federal dollars are building on existing efforts to enhance the health workforce pipeline by scaling up current training and retention programs for clinical providers and allied health professionals, as well as apprenticeship programs.
North Dakota Governor Kelly Armstrong and lawmakers supported spending $20 million for expanding rural primary care from its $398 million in RHTP money. Governor Armstrong said nearly 75% of North Dakota’s rural counties face primary care shortages.
“These challenges demand bold action. By expanding access, promoting long-term wellness and driving innovation, we have the chance to be the healthiest state in the nation.”
Pennsylvania Governor Josh Shapiro explained that in addition to RHTP, his 2025-26 budget makes “common-sense, strategic investments to further support Pennsylvania’s rural health care providers and access to health care in rural communities.
These include enhancing universal postpartum depression screenings and intervention efforts to ensure timely and equitable access to maternal and mental health care for mothers.”
Delaware Governor Matt Meyer in his State of the State spoke about gaps in access and affordability. “Too many Delawareans lack primary care,” and “Primary care appointments are still too limited, and emergency room wait times are too long,” he has said.
Delaware plans to boost primary care by addressing preventative care, sustainable access, workforce development, innovative care and tech innovation with RHTP support.
Separate from RHTP, New Mexico’s Rural Health Care Delivery Fund in 2026 has prioritized primary care projects from Medicaid-enrolled providers that address documented community needs in underserved areas. The state is allocating the money to 32 rural health care organizations, with $20 million in total. “We created this fund because rural health care providers were struggling to keep their doors open, let alone expand,” said Governor Michelle Lujan Grisham. “These awards will help meet a pressing need for care in rural communities that have gone too long without adequate services.”
Keen policy observers note that federal officials often recognize state-level successes and seek to advance such issues on a national level. For instance, in recent decades initial state achievements with health care access, education reform, welfare reform, crime reform, and other issues have served as examples and bolstered advocates as they pushed for change in Congress and with the Executive Branch.
The rural funding and the ways the states use it for primary care promise to provide valuable lessons not only for their states but the nation as a whole.
This legislation authorized health care delivery and payment system reforms including the expanded use of medical homes and ACOs. The law stipulates “Any integrated care model implemented on or after July 1, 2013, that delivers health care to medical assistance program recipients shall incorporate medical homes as its foundation.”