Kentucky is facing a shortage of nearly 3,000 physicians by 2030, according to an August 2025 report from the Cabinet for Health and Family Services.

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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.

Primary Care Access and Investment

Physicians make the case for funding primary care as a public good
Austin Littrell, Medical Economics
This article argues that primary care should be treated as essential public infrastructure rather than just another billable health care service. Littrell makes the case that stronger investment in primary care would improve access, reduce downstream costs and support healthier communities.

EXPERT PERSPECTIVE: How California’s public purchasers are joining forces to strengthen primary care
Drs. S. Monica Soni, Palav Babaria and Julia Logan, California Health Care Foundation
This piece explores how public purchasers in California are coordinating efforts to better support primary care. By aligning payment and accountability strategies, the initiative aims to strengthen preventive care, improve access and reduce fragmentation.

Massachusetts Primary Care Dashboard continues to highlight alarming trends for primary care
Massachusetts Health Quality Partners (MHQP)
The Massachusetts Primary Care Dashboard shows continued warning signs around access, workforce capacity and investment in primary care. The findings reinforce concerns that without stronger support, primary care practices may struggle to meet patient demand.

Ever have trouble getting a primary care appointment? This Mass. Senate bill could help
John L. Micek, MassLive
The Massachusetts Senate is preparing to vote on legislation intended to improve access to primary care and address health care affordability. The bill underscores how many state policymakers are increasingly viewing primary care investment as central to cost containment and patient access.

OPINION: Why America is failing its health report card
Robert B. Shpiner, The Guardian
This opinion piece critiques the high cost and uneven performance of the U.S. health care system. Its arguments connect to primary care by underscoring how underinvestment in prevention and frontline care can contribute to poor outcomes and high spending.

PERSPECTIVE: Cutting Through the Chaos in Primary Care
Dr. Fred Pelzman, MedPage Today
This commentary focuses on the role of patient-centered medical homes in improving care coordination and access. The model is closely tied to primary care because it emphasizes long-term relationships, team-based care and whole-person support.

Downcoding

Downcoding reform bill clears Illinois legislature on unanimous vote
Illinois State Medical Society, World Advertising Report
Illinois lawmakers advanced a bill addressing insurer downcoding practices, which can reduce payment for care already delivered. The issue is especially relevant to primary care practices that rely on predictable reimbursement to remain financially sustainable.

What physician practices need to know about insurance downcoding
Ansley Franco, Birmingham Medical News
This article explains how insurance downcoding affects physician practice revenue and administrative workflows. For primary care practices, downcoding can worsen financial strain and add to the burden of appealing claims.

Medicaid

New Medicaid Rules Imperil Primary Care Access
Ann Greiner, the PCC
The PCC issued a statement expressing disappointment toward the June 1, 2026, interim final rule affecting the Medicaid program. Read our full statement.

Medicaid work reqs IFR limits medically frail exemption, self-attestation
Dorothy Mills-Gregg, Amy Lotven, Sigi Ris, InsideHealthPolicy
This article examines new limits on self-attestation for medically frail Medicaid enrollees under work requirement rules. These documentation barriers could create coverage disruptions for patients who rely on Medicaid to maintain access to primary care and chronic disease management.

Industry groups say final Medicaid work requirements rule imposes onerous documentation
Paige Minemyer, Fierce Healthcare
Health care industry groups are raising concerns that Medicaid work requirement rules will create burdensome paperwork for patients, clinicians and state agencies. For primary care practices, coverage churn can interrupt preventive care and worsen health outcomes for vulnerable patients.

Medicaid work requirements: Experts say millions will lose coverage
Tara Bannow, Chelsea Cirruzzo and Daniel Payne, Stat+
Experts warn that Medicaid work requirements could lead to large-scale coverage losses, even among eligible individuals. Loss of coverage may reduce access to primary care, delay treatment and increase reliance on emergency departments.

Will CMS’ last-minute Medicaid work requirement changes cause more harm?
Marissa Plescia, MedCity News
This article looks at concerns surrounding CMS changes to Medicaid work requirement policy. The piece raises questions about whether administrative changes could increase confusion and make it harder for patients to maintain stable access to care.

Medicaid work requirements set with stricter medical frailty guidelines; critics push back
Melissa Patrick, Northern Kentucky Tribune
This article discusses stricter medical frailty guidelines connected to Medicaid work requirements. Critics argue the policy could make it harder for medically vulnerable patients to remain covered, affecting access to primary and preventive care.

Whole-Person Care

PCC Urges Administration to Listen to Clinician Voices on Vaccines
Ann Greiner, The PCC
The PCC has responded to an executive order issued on May 29, 2026 that instructs the Department of Health and Human Services to make additional changes to the childhood vaccine schedule. Read our full statement.

Why fragmented care misses older adults’ mental health needs
Creagh Milford, SmartBrief
This article examines how fragmented health care systems can overlook mental health needs among older adults. Integrating behavioral health into primary care could improve early identification, coordination and support for aging patients.

Millions skip colon cancer screening amid rise
Kaitlyn Mills, Considerable
This article highlights gaps in colon cancer screening despite rising concern about early-onset cases. Primary care clinicians are central to improving screening rates by counseling patients, identifying risk factors and coordinating preventive testing.

Health Insurance

Providers not seeing prior authorization improvement
Rich Daly, HFMA
Clinicians report that prior authorization reforms have not yet meaningfully reduced administrative burden. In primary care, prior authorization delays can slow referrals, testing, medications and care coordination.

States’ all-payer claims databases can help CMS more accurately value services
Shankar Mesta, Andre Chappel and Douglas Jacobs, Health Affairs
This article argues that state all-payer claims databases could help CMS better understand and value health care services. More accurate data could support payment reforms that better reflect the value of primary care and preventive services.

HMSA doctors can postpone transition to new payment model
Dan Nakaso, Honolulu Star-Advertiser
HMSA is allowing physicians to delay the transition to a new payment model for six months after concerns from Hawaii’s medical community. The delay may give primary care practices more time to adapt to payment changes that could affect operations and patient access.

Research and Data Hub

Curbing Primary Care Administrative Burden
The PCC
Learn in a new fact sheet how streamlining quality measurement, standardizing electronic prior authorization, advancing interoperability and reforming payment models offer clear pathways to reduce clinician burden, improve workforce satisfaction and strengthen overall care delivery.

Children’s well-being plummets across 29 states, report finds
Andria Park Huynh, HealthDay
A new report finds worsening child well-being across many states, raising concerns about mental health, economic stability and access to care. Primary care plays a key role in screening children, connecting families to services and identifying early warning signs.

State Watch

Report underscores the numbers behind RI’s primary care crisis
Jonny Williams, Providence Journal
A Rhode Island report finds that many residents continue to struggle to access primary care. The findings point to shortages, affordability concerns and system-level barriers that limit timely care.

HMSA’s payment system pivot has Hawaii’s medical community reeling
Nina Wu, West Hawaii Today
Hawaii physicians are raising concerns about changes to HMSA’s payment system and the potential effects on practice stability. Primary care practices may be particularly vulnerable when payment models shift quickly or without sufficient transition support.

Gillibrand says HHS administrative backlogs contribute to doctor shortage in NY
The Office of U.S. Senator Kirsten Gillibrand, Orleans Hub
Sen. Kirsten Gillibrand (D-NY) is raising concerns that federal administrative backlogs are contributing to physician shortages in New York. Delays in workforce-related processes can affect communities that already struggle to recruit and retain primary care clinicians.

Vermont lawmakers have adjourned for the year. Here’s what they did and didn’t do in 2026
Lola Duffort, Carly Berlin, Peter Hirschfeld and Bob Kinzel, Vermont Public
This article reviews major actions taken by Vermont lawmakers during the 2026 session, including primary care (and health care at-large) legislation.

WA is about to face even more of a shortage of family medicine doctors
Becca, Wolinsky, The Seattle Times
This opinion piece warns that Washington state may soon face worsening shortages of family medicine physicians. The article emphasizes the need for policy and training solutions that support the primary care workforce.

OPINION: California’s physician shortage demands practical solutions. AB 2386 is one of them
Lawson Mansell and Jonathan Wolfson, The Orange County Register
This opinion piece argues that California needs practical legislative solutions to address physician shortages. Strengthening the physician pipeline is especially important for primary care access in high-need communities.

Rhode Island has a primary care problem. Health Insurance Commissioner Cory King has a plan
Nancy Lavin, News From The States
Rhode Island’s health insurance commissioner is proposing strategies to address the state’s ongoing primary care access challenges. The article highlights the importance of payment reform, workforce support and stronger investment to stabilize primary care delivery.

North Huntsville clinic aims to expand access to primary care
Derek Lacey, Axios Huntsville
A North Huntsville clinic is working to address local primary care access needs in Alabama. The effort highlights how community-based clinics can help reduce gaps in underserved areas.

Artificial Intelligence (AI)

How ambient AI eases the pain of rural workforce shortages
Becker’s Hospital Review (in collaboration with Heidi)
This article explores how ambient AI tools may help reduce documentation burden in rural health care settings. For primary care clinicians facing workforce shortages, AI-supported documentation could free up time for patient care and reduce burnout.

PERSPECTIVE: Can AI Save the Primary Care Exam Room From Quality Creep?
Dr. Jeffrey Millstein, MedPage Today
This commentary focuses on the double-edged sword that AI advancements bring into primary care, arguing that it “can restore the doctor-patient relationship or entrench metrics that have strained it.”

This compilation was created with support from an AI tool.

The Centers for Medicare & Medicaid Services launched its framework for Medicaid work requirements on Monday, June 1, which are now required under HR-1, or the federal One Big Beautiful Bill Act.

This bill adds the Psychiatric Collaborative Care Model as a behavioral health delivery method to Kentucky’s health code and requires health plans providing mental health coverage to reimburse these services using the CPT codes established in federal regulation for this model.

Signed into law on April 12, 2026.

On Wednesday, May 20, the House Energy & Commerce Subcommittee on Health held a hearing entitled, “Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms.” It marked the fourth hearing in the Committee’s health care affordability series—and primary care took center stage at the hearing.  

Witnesses included: 

• William Fox, MD, MACP, Chair Emeritus, American College of Physicians Board of Regents, Fox & Brantley Internal Medicine  

• Steven Furr, MD, FAAFP, Family Medicine Physician and Former President of American Academy of Family Physicians 

• Dana Smetherman, MD, MPH, MBA, FACR, Chief Executive Officer, American College of Radiology  

• Rick Snyder, MD, President, HeartPlace  

• Farzad Mostashari, MD, Chief Executive Officer and Co-Founder, Aledade 

Representatives and witnesses emphasized the critical role primary care plays in improving the health of Americans. Yet despite its importance, primary care remains chronically underinvested in and continues to face a growing workforce shortage. Lawmakers repeatedly sought solutions to better incentivize and support medical students and practicing primary care clinicians in entering and remaining in the field. 

A recurring theme throughout the hearing was the idea of primary care serving as the “quarterback” of the American health care system. Speakers highlighted primary care as a critical entry point, providing chronic disease prevention, care coordination and lifestyle medicine through trusted, long-term patient-clinician relationships. Witnesses and members alike noted that stronger investment in primary care is associated with improved health outcomes and lower overall health care costs. 

Five major themes emerged from the hearing: 

Primary Care as the Backbone of a Healthy America 

Ranking Member Diana DeGette (D-CO-01) emerged as a champion for primary care during the hearing. In her opening statement, she described primary care as “the backbone of a healthy population.” Drawing from her personal experience as the mother of a primary care physician, Rep. DeGette emphasized the need to strengthen primary care through increased investment and improved reimbursement for primary care services. 

Other members, including Representatives Kelly (D-IL-02) and Carter (D-LA-02), also highlighted the integral role primary care plays in supporting seniors living with one or multiple chronic conditions. 

Greater Investment in Primary Care & Hybrid Payment Models  

Representatives from across the health care field emphasized that Medicare Physician Fee Schedule reimbursement rates have failed to keep up with inflation. When asked how best to support primary care clinicians in serving complex patient populations, Drs. Fox and Furr stressed the importance of both greater investment in primary care and expanded access to hybrid payment models. 

They argued that upfront per-member-per-month payments (PMPM), coupled with fee-for-service reimbursement, gives clinicians greater flexibility to manage patient needs, build care teams, invest in technology and deliver more comprehensive whole-person care.  

Representatives John Joyce (R-PA-13 ) and Gus Bilirakis (R-FL-12) also emphasized the need to strengthen the primary care workforce by incentivizing medical students to enter the specialty and by modernizing the Medicare reimbursement system to better support independent primary care practices.

Supporting Rural Communities  

Supporting America’s rural health communities stood out as a bipartisan priority throughout the hearing. Representative Carter (D-LA-02) emphasized the challenges facing rural populations during his opening remarks, stating: 

“Rural patients are sicker and older, have a higher risk of chronic disease, and are more likely to rely on Medicare and Medicaid. This is a patient population that needs more access, not less, yet they are more likely to face barriers to care because there simply are not enough doctors.” 

Witnesses took the opportunity to stress the importance of training the next generation of clinicians in rural settings, noting that physicians are more likely to practice in the communities where they train. Several witnesses encouraged Congress to increase reimbursement for Graduate Medical Education (GME) training opportunities and expand hybrid payment models that would allow clinicians to build care teams, reduce administrative burden and better support rural patient populations. 

Reducing Administrative Burden for Clinicians  

Reducing administrative burden surfaced as a key priority, with several members focusing their questioning on how streamlining reporting requirements could give clinicians more time for direct patient care and help sustain independent practices. Representative Guthrie (R-KY-02) specifically raised concerns about the burden associated with programs such as MIPS and the disproportionate impact reporting requirements have on rural and small independent practices. 

Both lawmakers and witnesses called for greater standardization and simplification of reporting requirements to reduce administrative burden and allow clinicians to spend more time caring for patients. 

Consolidation of Independent Practices 

Lawmakers sought to better understand both the root causes of vertical integration and its downstream effects on patients and clinicians. Committee members raised concerns about the number of independent practices being bought up by larger health systems and the unintended consequences consolidation can have on patient access and choice. 

Witnesses and lawmakers testified that financial instability, growing administrative burden, clinician burnout and persistent staffing shortages, has contributed to the decline of independent practices. Witnesses also pointed to existing federal incentives that make it easier for hospitals and health systems to acquire smaller practices. 

Dr. Furr explained that operating an independent practice is like running a small business, noting that without stable reimbursement, many practices struggle to remain financially viable while continuing to support the needs of their patient populations. 

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 Kentucky.