Washington, D.C. (June 2, 2026) – Primary Care Collaborative (PCC) President and CEO Ann Greiner has issued the following statement in response to an executive order issued on May 29, 2026 instructing the Department of Health and Human Services to make additional changes to the childhood vaccine schedule:

“Vaccines play a central role in prevention and are a critical part of high-quality, whole-person primary care. For decades, the United States vaccine schedule has been guided by A-plus science that is focused on the particular health threats our nation faces.

“We urge the Administration to continue following the recommendations developed with input from clinicians across the nation who strive to deliver the best possible care to their families, friends and neighbors.”

Washington, D.C. (June 1, 2026) – Primary Care Collaborative (PCC) President and CEO Ann Greiner has issued the following statement in response to the June 1, 2026, interim final rule affecting the Medicaid program:

“The PCC is disappointed by today’s interim final rule, which would further imperil access to high-quality primary care. These top-down changes will force states to implement new requirements that will hamper access to preventive services and primary care.

“At a time when families already struggle to gain access to needed primary care and preventive services, finalizing this regulation will undermine stability of practices across the nation. We urge policymakers to press pause on these concerning policies.”

Today’s announcement closely followed a proposed Special Directed Payment rule that would eliminate $510 billion from state Medicaid budgets—far outpacing the $149 billion score estimated by the CBO when H.R. 1 was passed – and further weakening the nation’s health care safety net.

Washington, D.C. (May 22, 2026) – The Primary Care Collaborative (PCC) is concerned by the termination of Dr. John Wong and Dr. Esa Davis from the United States Preventive Services Task Force (USPSTF).

“The USPSTF plays a central role in ensuring American families have access to critical preventive services that are the underpinning of primary care,” said Ann Greiner, President and CEO of the PCC. “This move undermines the integrity of USPSTF and engenders distrust in the committee’s vital work to advance evidence-based prevention.”

Last summer, the PCC joined with 103 other organizations urging policymakers to preserve the integrity of the USPSTF by protecting and preserving the USPSTF’s current structure and operations.

“We urge the Secretary and HHS to preserve the remaining members of the task force and allow them to proceed with the evidence-based approach that has been the hallmark of the USPSTF,” continued Greiner.

Since its inception, the Task Force has issued nearly 300 recommendations through a rigorous, multi-step process in collaboration with the public, evidence-based practice centers, and experts in primary care and clinical research.

On May 20, the Primary Care Collaborative filed the following Statement for the Record with the House Energy and Commerce Subcommittee on Health for its hearing, “Examining the Medicare Physician Fee Schedule, MACRA and Opportunities for Payment Reform.” The statement urges lawmakers to center primary care in Medicare payment reform by enacting policies that expand viable pathways to move beyond fee-for-service medicine and foster whole-person primary care in value-based models.

Policy recommendations include:

1. Properly Value Primary Care: Congress must address the persistent undervaluation of primary care that drives inadequate investment in primary care. It is also vital that CMS explore alternative data sources, beyond surveys, to gain a more complete understanding of the value of different services. Pairing stronger investment with proper valuation going forward can help reverse trends that have contributed to workforce shortages exacerbating access issues across the nation.
2. Implement Hybrid Payments: Congress should pair stronger investment in primary care with a smarter approach to payment by implementing hybrid payments, as recommended by the National Academies of Science, Engineering and Medicine.11 Hybrid payments provide primary care with fixed, regular upfront payments to help meet usual health needs of their patients—such as preventing chronic disease and chronic disease complications—while also providing additional fees for high-value, underprovided services.
3. Reform and Cut Red Tape in MIPS: Policymakers must address burdensome red tape created by the MIPS program by simplifying and refocusing quality metrics on what matters, including continuity of relationships and comprehensiveness of services. Developing a simpler, and where possible outcome-focused, approach to quality measures—and potentially aligning with other payers—could help eliminate hours of unnecessary paperwork.
4. Eliminate Cost Sharing for Primary Care: Medicare beneficiaries need your help to remove unnecessary cost-sharing barriers to primary care. These barriers to care create administrative friction, places needless financial burdens on accessing high-value care for American families and prevent far too many people on Medicare from seeking the type of preventive care essential to better health. Eliminating these barriers is particularly important for expanding care management and integrated behavioral health services, which play a critical role in keeping people healthy.
5. Ensure Whole Person Care: Primary care should be comprehensive, coordinated and relationship-based. To support patients in successfully achieving their health goals, practices must have the resources and staff to respond, address and coordinate physical, behavioral and social care across multiple settings. Stronger primary care teams should include behavioral health clinicians, pharmacists, social workers and care managers capable of supporting patients with chronic disease and behavioral health – and connect them to social care and community resources.

Read the full statement for more details.

The Problem Is Bigger Than Many Realize

When the Primary Care Collaborative set out to further examine administrative burden in value-based primary care, we expected to find a serious problem. What we found was a crisis — one that is quietly undermining everything we are trying to build in the shift toward value-based care.

While the issue has been known, the magnitude remains striking. Studies show that nearly half of a physician’s office day is consumed by EHR and desk work, with only about a quarter spent in direct clinical contact with patients. Primary care physicians in the U.S. spend roughly $20 in administrative costs for every $100 in clinical revenue generated. And after the office day ends, clinicians report spending one to two additional hours each evening on EHR-related tasks — the work that never makes it onto the schedule, never gets billed, and never stops.

These statistics describe more than inefficiency. They describe a system that is asking its primary care workforce to absorb the costs of complexity that the broader health system generates — and doing so without adequate compensation, infrastructure, or relief.

For me, reading this report as both a board member of the PCC and someone who works in health care technology, there is a particular kind of accountability in these findings. The technology sector has enormous potential to be part of the solution. But if we are honest, we have also contributed to the problem.

The Technology Opportunity — and Responsibility

This is where I want to speak directly from my experience in health care technology. The tools we build for primary care have an outsized impact — for better and for worse. When technology is well-designed, interoperable, and thoughtfully integrated into clinical workflows, it reduces burden. When it is fragmented, vendor-locked, opaque in its costs, or optimized for billing rather than care, it adds to the very burden it was supposed to solve.

The PCC’s report makes a critically important point: technology vendors need to be transparent about the full costs and capabilities of their tools. Practices need to be able to make informed, proactive decisions about what they can rely on. Too often, that transparency is absent — and practices pay the price in integration costs, workflow disruption, and tools that do not deliver on their promises.

The report also identifies a genuine opportunity in the emergence of AI-enabled tools. Ambient AI scribes are already being introduced in primary care settings with promising results. A 2025 study across six academic and community-based practices found that use of ambient AI scribes was associated with meaningful reductions in burnout, cognitive task load, and after-hours documentation time. Clinicians reported greater ability to focus on patients during encounters. That is not a marginal improvement — it is the kind of change that can restore meaning to the practice of medicine.

Beyond ambient scribes, agentic AI — systems trained to review, triage, and respond to inbox messages, patient portal requests, and administrative tasks — is moving rapidly from concept to deployment. Dr. Yair Lewis of Navina, speaking at a PCC webinar in October 2025, predicted that AI agents will become commonplace in primary care.  The question is not whether these tools will reshape primary care workflows, but whether they will do so in ways that genuinely reduce burden and improve care — or in ways that create new forms of complexity, liability, and inequity.

Safe AI in Primary Care: A Framework for Getting It Right

Through my work in health care technology, I spend a significant amount of time thinking about what “safe” AI adoption looks like in the primary care context. The PCC’s report is appropriately cautious, noting that the “let a thousand flowers bloom” approach to AI adoption carries real risks. Lisa Bari of Innovaccer and Dr. Sara Pastoor of Elation Health both raised concerns about unintended consequences at the October 2025 PCC webinar. Those concerns deserve to be taken seriously.

For AI tools to deliver on their promise in primary care, several conditions need to hold. First, patient consent and transparency must be treated as non-negotiable, not as implementation details. As AI applications proliferate, the question of whether patients are comfortable with AI-mediated interactions in their health care will become increasingly important. Trust, once lost, is difficult to rebuild.

Second, AI tools must be evaluated rigorously for impact — not just on administrative efficiency, but on the quality of clinical documentation, the accuracy of billing and coding, and the downstream effects on patient care. The concern raised in the literature is real: will ambient AI scribes and agentic tools be used primarily for revenue optimization, or will they genuinely improve the clinician-patient interaction? The answer will depend on how these tools are designed, deployed, and governed.

Third, the economics of AI adoption must be incorporated into payment models. The PCC report is explicit on this point: the cost of technology and digital infrastructure needed to provide high-quality care must be accounted for in payment rates. Solo practices and small independent practices — which serve a disproportionate share of rural and underserved communities — cannot bear these costs on their own. If AI is going to reduce burden equitably across the primary care landscape, the financial structure has to support broad adoption, not just adoption by well-resourced systems.

The plea embedded in that survey response is worth sitting with. The people closest to the problem are not asking for more software. They are asking for support — human, financial, and structural. Technology is most valuable when it amplifies that support, not when it substitutes for it.

What Needs to Happen Next

The PCC’s report is not simply a diagnosis. It is a call to action — and it identifies specific responsibilities for every stakeholder in the system. For example, APCM is an encouraging example of what’s possible: a streamlined billing approach that pays for between-visit care without requiring minute-by-minute documentation. That same spirit of simplification needs to extend to quality reporting, prior authorization, and data exchange requirements.

Let me be direct about what I believe needs to happen.

Technology companies must be accountable partners. Transparent pricing. Honest capability claims. Interoperability as a design principle, not an afterthought. Rigorous evaluation of clinical and administrative impact. These are not aspirational standards — they are the baseline that primary care practices deserve from their technology partners. The tools we build should serve clinicians and patients, not complicate their lives.

And the primary care community must keep speaking. The PCC’s survey captured voices from across the primary care landscape, and the message is consistent: the burden is staggering, the consequences are real, and the time for incremental responses has passed. Health system leaders, payers, and technology companies will act with greater urgency when they hear clearly from the clinicians and communities who are bearing this burden every day.

A Personal Note

I came to the work of the Primary Care Collaborative because I believe that primary care is the foundation on which every other improvement in American health care depends. You cannot build a high-value health system without a strong, sustainable, trusted primary care infrastructure. And you cannot have that infrastructure if the people who deliver primary care are spending half their working hours doing administrative tasks that have little to do with patient care.

The technology sector I am part of has a genuine opportunity to change this — to build tools that give clinicians time back, reduce the friction of data exchange, and make the transition to value-based care less costly and more achievable for practices of every size. But technology alone will not solve a problem that is structural. Payment reform, policy alignment, and a genuine commitment across stakeholders to reduce burden rather than redistribute it — that is what the PCC’s report is calling for. I think it is right.

I encourage health system leaders, payer executives, and tech companies working in this space to read the full report. The PCC has done the work of translating a complex, multifaceted problem into an actionable framework. What happens next depends on how we address these underlying challenges and not further compound the situation with surficial approaches.

This piece was created with support from an AI tool.

A New Payment Model That Reflects How Primary Care Actually Works

For years, primary care clinicians have been doing work that the fee-for-service system simply didn’t pay for: managing complex patients between visits, coordinating care across specialties, reaching out to high-risk individuals before a crisis, and keeping continuity alive in a fragmented system. That work was invisible in the payment model — and that invisibility had consequences.

Advanced Primary Care Management (APCM), launched by the Centers for Medicare & Medicaid Services (CMS) on January 1, 2025, changes that calculus. For the first time, Medicare is offering primary care practices a monthly bundled payment that captures the full scope of care management — without the administrative burden of minute-by-minute time tracking that made earlier programs like Chronic Care Management so difficult to scale.

The Primary Care Collaborative (PCC) has been active in this policy development from the beginning — engaging CMS leaders, practice representatives, and health system stakeholders to shape the program, provide feedback, and help the field understand how to put APCM into practice. Our recent webinar, “Advanced Primary Care Management: Successful Implementation,” brought those conversations to life with direct insights from the organizations implementing this program on the ground.

Why APCM Is a Meaningful Step Forward

What makes APCM genuinely different is what it doesn’t require. Unlike time-based care management codes, practices do not need to document every minute spent on patient management to bill APCM. Instead, they must demonstrate capacity across 13 service elements — including 24/7 care access, care plan development, transitional care management, behavioral health coordination, and risk stratification — and deliver them as clinically appropriate for each patient. This is how high-performing primary care teams have always operated. APCM simply creates a payment structure that reflects that reality.

APCM is structured around three billing codes — G0556, G0557, and G0558 — tiered by patient complexity. Patients with one or fewer chronic conditions qualify for Level 1; those with two or more qualify for Level 2; and patients who are both medically complex and Qualified Medicare Beneficiaries — among the most vulnerable and costly patients in the Medicare population — qualify for Level 3. Reimbursement rates increased approximately 10 percent in the 2026 Medicare Physician Fee Schedule and CMS has continued to expand the program by creating add-on codes for behavioral health–an important sign that  CMS is committed to growing this program.

What Practices Are Experiencing on the Ground

Our webinar surfaced practical, on-the-ground insights from practices that have moved beyond the planning stage and are actively billing APCM for their Medicare patients. Several key themes emerged.

The administrative relief is real. The shift away from time-based documentation has freed clinical staff to focus on patient care rather than stopwatch management. For practices that struggled with the documentation requirements of Chronic Care Management, APCM has proven to be a more sustainable model — one that aligns with how care teams naturally work.

Patient engagement is improving. The structure of APCM — with its emphasis on proactive outreach, care planning, and between-visit communication — is strengthening the longitudinal relationships that define high-quality primary care. Patients enrolled in APCM hear from their care team more consistently, and that continuity is producing measurable benefits in chronic disease management and care gap closure.

The revenue matters. For independent and small practices operating on thin margins, the predictable monthly APCM payment provides a financial stabilizer. The program does not require the infrastructure investment of more complex alternative payment models, making it accessible across the full range of primary care settings — including federally qualified health centers and rural health clinics, which became eligible for APCM billing beginning mid-2025.

PCC’s Role: Shaping the Program and Advocating for Improvement

The Primary Care Collaborative has been a consistent and influential voice in APCM’s development. In July 2024, the PCC convened an online discussion with senior CMS leaders — including Dr. Meena Seshamani, Deputy Administrator and Director of the Center for Medicare, and Dr. Doug Jacobs, Chief Transformation Officer of the Center for Medicare — to examine how the new APCM codes could strengthen primary care under the Physician Fee Schedule. That forum helped translate CMS’s policy intentions into practical understanding for the primary care community and surfaced critical feedback from practices on the ground.

The PCC has sustained that engagement as APCM has moved from proposal to implementation. Our advocacy has focused on the areas where the program can go further: reducing patient cost-sharing, which remains a barrier to enrollment for many Medicare beneficiaries and an administrative burden for practices; expanding APCM so that it could function as a hybrid payment; and ensuring that safety net providers and the communities they serve can fully access the program’s benefits.

Those advocacy efforts are producing results. Following recommendations from the PCC and its members, the 2026 Medicare Physician Fee Schedule included new behavioral health add-on codes for APCM — a direct response to the PCC’s long-standing position that mental health integration is a core component of advanced primary care. CMS has also signaled openness to incorporating more preventive care services into the bundle, another PCC priority.

What Comes Next

APCM is explicitly described by CMS as a multi-year effort — a first step toward something more comprehensive. The agency has signaled interest in developing a hybrid payment model that combines APCM’s population-based monthly payment with traditional fee-for-service for appropriate services, creating a more complete infrastructure for team-based, whole-person primary care.

This is the direction the PCC has championed, and the direction the evidence supports. Health systems and payers that align their contracting strategies, care team design, and technology investments with APCM’s framework now will be well-positioned as this evolution continues. We are seeing that the practices that adopt APCM today are not just capturing revenue — they are building the workflows, patient relationships, and population health competencies that will define high-performing primary care for the decade ahead.

Watch the Webinar and Join the Conversation

If you weren’t able to join us live for “Advanced Primary Care Management: Successful Implementation,” the recording is now available on demand. Our speakers, Dr Jake Quinton, CMS; Dr Sam Hiatt, Community Care of North Carolina; Cristina Boccuti, AARP; Dr Jason Lofton, Lofton Family Clinic explored the practical realities of APCM adoption, answered questions from practices at every stage of implementation, and discussed what the next phase of primary care payment transformation looks like.

Whether you are a practice administrator evaluating APCM for the first time, a health system leader thinking about how to support your primary care network, or a payer looking to align contracting strategy with this emerging model — this webinar offers concrete, actionable perspective.

Watch the Webinar On Demand

Click here to watch “Advanced Primary Care Management: Successful Implementation”. For questions about APCM, PCC membership, or how to engage with PCC’s advocacy on primary care payment reform, reach out to PCC’s Policy Director, Larry McNeely (lmcneely@thepcc.org).

The Primary Care Collaborative will continue to convene, inform, and advocate as APCM matures. We invite you to be part of that work.

This blog was originally posted by PCC Board Chair Sean Hogan on LinkedIn. Click here to read the original post. 

Washington, D.C. (May 08, 2026) – Primary Care Collaborative (PCC) President and CEO Ann Greiner has issued the following statement in response to efforts by CMS to streamline prior authorization:

“We appreciate the Administration exploring ways to reduce the red tape and bureaucracy that hinders primary care from delivering care patients need.

“We look forward to learning more about these initiatives to streamline prior authorization and gaining a deeper understanding of their impact on removing unnecessary and harmful barriers to care.

“The PCC and its members stand ready to work with the Administration toward simplifying care–including by discussing some of the ideas released in a recent policy options brief.”

More and more Americans can’t find affordable health care. And they’re making sure Washington knows they aren’t happy about it.

A March 2026 Gallup poll found that Americans say the availability and affordability of health care is their top policy concern. Eighty-four percent of the country labeled this key issue as one they personally worry about at least “a fair amount,” with a whopping 61% personally worrying over this problem “a great deal.”

It’s easy to see why people are worried. High costs and difficulty accessing care have made Americans less healthy. A September 2024 Commonwealth Fund report found that the United States ranked dead last on multiple key health care measures compared to other developed countries.

And people’s pocketbooks are suffering, too. One third of Americans have had to cut back on daily expenses just to cover their health care costs. This includes an estimated 28 million people skipping a meal to pay for care or medicine. All the while, the United States invests the most out of any country in health care — throwing $5.3 trillion a year at the problem.

Unfortunately, these findings aren’t surprising. For decades, the American health system has been focused on delivering more—rather than better—care. An overemphasis on services instead of outcomes has led to widespread misvaluing in health care.

Nowhere is that clearer than in primary care, which has faced chronic underinvestment. Despite decades of evidence proving that whole-person primary care generates savings and improves people’s health, primary care remains dangerously underfunded, accounting for less than five cents of every health care dollar.

That underinvestment has contributed to a shortage of primary care clinicians—directly causing many of the access issues Americans are frustrated by today.

It’s beyond time for policymakers and industry leaders to act to address these underlying issues and the Primary Care Collaborative and our members have developed concrete solutions they can begin implementing today, including:

• shifting away from a fee-for-service (FFS) payment model toward a hybrid model (a mix of population based and fee-for-service payment)
• plainly investing more of America’s health care dollars into primary care
• implementing strategies to simplify value-based primary care by reducing administrative burdens

By implementing these pragmatic solutions to shift our health care payment system to reward health and wellness, policymakers and industry leaders can show they’re taking the American publics’ concerns about affordability to heart. Keeping Americans healthy is good for their and the nation’s pocketbooks.

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.