On April 16, 2025, the PCC hosted a webinar exploring how key players in North Carolina are working together to streamline value-based care in primary care settings. This webinar serves as the first of a two-part series exploring the factors behind shorter patient visits, longer wait times and new patient fees in primary care.
Panelists included Greg Moon, MD, MBA (Blue Cross North Carolina), Rebecca Whitaker, PhD, MSPH (Duke-Margolis Institute for Health Policy) and Tom Wroth, MD (Community Care of North Carolina) with Ann O’Malley, MD, MPH (Mathematica) moderating.
Before the webinar kicked off, PCC Communications Director Tod Didier reminded viewers of the organization’s upcoming 2025 Conference: Scaling What Works for Better Health. Taking place in DC from June 4-5, this conference will host compelling conversations exploring how innovative new approaches to primary care delivery and payment may be successfully scaled. You can register for the event here.
O’Malley began by presenting findings from a Commonwealth Fund–supported qualitative study exploring why many primary care clinicians have not joined Value-Based Payment (VBP) models. Interviews with frontline clinicians and experts found three main barriers: financial constraints, overly burdensome and misaligned performance measures, and a workforce shortage exacerbated by administrative strain. Despite recognizing the potential of VBP models, significant practical and systemic challenges to participation were cited.
Whitaker described North Carolina’s State Transformation Collaborative (STC), a multi-stakeholder initiative supported by the Centers for Medicare and Medicaid Services and the Health Care Payment Learning & Action Network. It’s aimed at advancing value-based, whole-person care.
Wroth then emphasized that the STC was a “no-brainer” for supporting North Carolina’s overwhelmed independent practices. Moon agreed, praising the collaborative for fostering ecosystem-wide dialogue and alignment as well as providing critical insights into model design, technologies and shared challenges that individual organizations might overlook.
Whitaker highlighted performance measure misalignment, data challenges and social needs data collection as major burdens on primary care. Wroth stressed the need for measure alignment and simplified reporting to ease the burden on small practices using dozens of EHRs, crediting the STC’s leadership for driving action. Moon highlighted that provider feedback, including through the STC, helped directly shape Blue Cross North Carolina’s shift to a more sustainable, lower-burden value-based model.
Wroth emphasized the need to focus on achievable goals, like aligning performance measures and improving data to address disparities. The group worked within existing performance and contracting cycles to create practical solutions.
Moon noted the power of collective voices and the potential of automation and digitization to reduce manual work and optimize resource use.
Whitaker discussed the strategy of engaging stakeholders to build consensus on shared goals and solutions, especially around performance measures and data sharing, while adapting to varying organizational capabilities. Wroth pointed out that convening stakeholders was relatively low-cost. Whitaker suggested leveraging existing resources like North Carolina Medicaid to support the work.
Regarding shared platforms, Moon recognized growing momentum around data exchange. Wroth and Whitaker supported using the North Carolina HIE for better data sharing and performance measurement, stressing data quality.
Wroth highlighted the challenges of working with multiple EHR systems but focused on efforts to streamline data reporting through public utilities like the HIE.
Answering questions from the audience, panelists acknowledged the role of primary care in reducing the total cost of care (TCOC) but called for better tools to manage non-primary care spending, particularly in transitional care. They also highlighted the need to streamline credentialing and payer contracts through a universal application process.
Finally, the importance of patient participation was underscored, particularly in health disparities data discussions. They emphasized the need for diverse perspectives and meaningful engagement in the future.
As the webinar concluded, PCC Communications Director Tod Didier once again reminded viewers of the organization’s upcoming 2025 Conference: Scaling What Works for Better Health. Taking place in DC from June 4-5, this conference will host compelling conversations exploring how innovative new approaches to primary care delivery and payment may be successfully scaled. You can register for the event here.
Webinar Series: Why Don’t Patients Have More Time with Primary Care?
The PCC is hosting a two-part webinar series in 2025 that will explore the factors behind shorter patient visits, longer wait times, and new patient fees in primary care. Primary care participation in value-based payment models often means more quality measure reporting, chart documentation, and care coordination, with practices waiting a year or longer for uncertain shared savings. These costs are crushing primary care practices and clinician morale and reducing time for direct patient care.
