Chronic Care in Medicare Fact Sheet Preview

Chronic Care in Medicare: How Congress Can Strengthen the New APCM

Advanced Primary Care Management services—launched by Medicare in 2024—show enormous promise in supporting primary care to deliver whole-person primary care. By creating a single, bundled payment that eliminates the need for time-tracking, the new program aims to make it easier for primary care to focus on helping patients manage their care more effectively.

While the program has enormous potential, some primary care practices have experienced challenges implementing the program—especially mandatory cost-sharing. In a new fact sheet, the Primary Care Collaborative and West Health provide insights into how policymakers can help remove one of the biggest hurdles to widespread adoption of APCM.

Primary care is ground zero for lifestyle medicine

Key takeaways:

  • PCPs are uniquely positioned to help patients achieve healthier lives through lifestyle medicine.
  • Lifestyle medicine does not require perfection. It starts with partnering with patients to design healthier lives.

[…]

Concept of US national healthcare system - state of Texas

What Texas Can Teach Us About the Crisis in Primary Care

Across the United States, primary care is widely recognized as essential to improving health outcomes, controlling costs, and advancing equity. Despite this broad consensus, states struggle to find ways to reform their primary care systems to provide critical care in an accessible, financially viable way that recognizes complex workforce issues.

Texas offers a useful lens to this challenge, not because it is unique, but because it amplifies many of the structural dynamics shaping primary care nationally.

[…]

Newspaper with computer on table

What We’re Reading 6/26/26

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.


The Voices of Primary Care

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 Investment

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.

 

Growing the Pipeline Where It Matters Most: Why Expanding Residency Training Is Critical to Solving the Physician Shortage

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.


Medicare

Sen. Angus King Introduces Legislation to Make Primary Care and Mental Health Services More Available

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.


Medicaid

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.


Downcoding

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.


Whole-Person Care

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.


Research and Data Hub

From the Federal Government to the Front Lines of Primary Care: Lessons Learned in the Fight to Strengthen the Foundation of Health Care

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.

 

The Medical School Boom

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.

 

New Survey Shows Michiganders Face Growing Wait Times, Want More Options, Choice and Access to Nurse Practitioners

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.


State Watch

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.


Artificial Intelligence (AI)

[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.


Health Insurance

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.

Newspaper with computer on table

What We’re Reading – 6/12/26

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.