Legislation would gradually boost primary care spending over time

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After decades of advocacy, Atkinson sees a glimmer of hope in the form of a sprawling bill that recently passed in the House of Representatives. The legislation would significantly boost investment in primary care, though it’s unclear if the funding will hold as House and Senate negotiators must now reconcile the two chambers’ packages.

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On July 30, something happened in the Massachusetts House that primary care doctors like me have been waiting years to see: the House passed H.5618, the PC4YOU bill, with a unanimous vote. The Senate passed its own version back in June. For the first time in a long time, it feels like Beacon Hill is taking the primary care crisis seriously.

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Direct primary care (DPC) is nearing an inflection point, driven by new tax incentives, employer demand and a wave of state laws, said the head of a national coalition representing direct primary care physicians.

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Massachusetts should invest more in primary care, but lawmakers must also protect the hospitals that care for the state’s most vulnerable patients amid looming federal cuts.

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The bill seeks to require hospitals and other “health care entities” to incrementally increase primary care spending. It would require them to invest 15% of their total expenditures in primary care by 2030, without increasing overall spending or insurance premiums.

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House Speaker Ron Mariano has expressed skepticism about the Senate’s primary care bill, but said he’s got his eye on “prescription drug stuff” with only about two weeks remaining to get major bills before negotiating panels.

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Here’s how the slow painful death of primary care threatens specialists and undermines the overall functioning of our health care system

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Documentation burdens, frequent renewal deadlines, and complex reporting rules will push residents off MassHealth, unless the state takes deliberate steps to help people navigate the system. Those most at risk, including people with behavioral health conditions and unstable housing, are also the least able to navigate these requirements on their own, making investment in the behavioral health safety net essential to keeping them covered.

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This bill creates a primary care council representing key health stakeholders to develop and recommend a prospective payment model for primary care providers. It also requires entities to create primary care spend targets and creates incentives for evidence-based services such as integrated behavioral health.

The bill also creates a primary care stabilization fund to support these payments, with annual reporting and oversight by the health policy commission.