On December 18, the Primary Care Collaborative (PCC) and Harvard Medical School (HMS) hosted a webinar for the release of the Primary Care Investment Guide. The guide breaks down how advanced primary care services such as behavioral health integration, clinical pharmacy services, care management, population health and social needs interventions lead to better outcomes for patients.
The webinar opened with Ann Greiner (Primary Care Collaborative) welcoming participants and introducing the release of the Primary Care Investment Guide from the Harvard Medical School Center for Primary Care.
The report was described as a practical resource for policymakers, payers, purchasers and leaders of the healthcare system to improve primary care and add greater value to the health care system. Greiner also thanked the California Health Care Foundation and The Commonwealth Fund for supporting this effort.
Dr. Russ Phillips (Harvard Medical School) went on to describe that what stimulated this project was a growing concern at a national level for access and a growing recognition of the importance of investing in primary care. While this is a welcome trend, greater investment does not solve the problem without strategic spending.
He described the study’s aim as learning from organizations already investing in primary care to understand impacts, costs, returns and lessons learned. Dr. Phillips then introduced the rest of the Harvard research team, including Dr. Amie A. Pollack, Dr. Zirui Song and Dru Ricci.
In discussing the results, Dr. Pollack identified a persistent lack of investment in primary care as an underlying cause of workforce shortage, burnout among health care workers, lack of coordination of care and issues with patient access. By using a mixed methods design that leveraged qualitative research in five states, analysis of financial information and literature searches, Pollack identified investments in high-value primary care services in areas like behavioral health integration, clinical pharmacy, care management, population health management, social determinants of health support and e-consult services.
Organizations have shown improvements in care delivery and use, despite the lack of published evidence for cost savings being more service-dependent, according to Pollack. She also highlighted that flexible up-front investment, leadership engagement and team care were key components in the wake of challenges in primary care like personnel, data and reimbursement.
The discussion then turned to a reaction panel that included speakers Ipek Demirsoy (CMS Innovation Center), Dr. Anna Flattau (Jefferson Health), Dr. Todd May (Health Net) and Dr. Hemi Tewarson (National Academy for State Health Policy).
Demirsoy praised the level of detail in the report, saying that it represents an improvement over a generalized call for more investment in primary care. Spelling out specific ways in which such investments can be made effectively, she noted it also recognizes states’ key responsibility in multi-payer alignment. She also stressed that more primary care investment will require greater transformative change in hospitals and specialties.
Dr. Flattau appreciated the encouragement and integration of infrastructure and organization findings across the report and stressed that it is imperative that these be aligned with more operational findings related to delivery and care teams and patient relationships. Flattau emphasized that primary care cannot be made into a “charity case,” and that adequate funding is required regarding transformation efforts.
From the payer’s perspective, Dr. May highlighted the report’s emphasis on using hybrid payment models. He cited an example concerning a California multi-payer demonstration project that includes Health Net, Aetna and Blue Shield and captured the essence through initial investment and use of common data platforms and metrics as well as coaching. Some of the challenges picked include payer resistance to collaboration, lack of transparency concerning how funds flow to the front lines and government restrictions, mostly in the Medicaid program.
Dr. Tewarson reflected on the report from a state policymaking perspective. She noted strong alignment between the report’s findings and what state leaders are experiencing, particularly around affordability pressures and workforce challenges.
Tewarson identified primary care investment targets, infrastructure for practice transformation and leveraging time-limited opportunities such as the Rural Health Transformation Fund as key factors to drive lasting change. However, she cautioned that sustaining momentum requires embedding primary care within broader state strategies on access, affordability and health system reform.
During a Q&A, Dr. Song addressed methodological questions and offered a synthesis of federal, state and private-sector approaches to strengthening primary care. He noted that federal efforts often rely on new billing codes, which are frequently underused due to limited practice capacity and patient cost-sharing concerns.
Song argued that prospective, per-member-per-month funding can help practices build the infrastructure needed to deliver advanced services. He also suggested that states may have flexibility to support primary care outside the fee schedule in payer-agnostic ways, potentially creating more stable and equitable investment models.
Ultimately, speakers agreed that while the primary care crisis is ongoing and significant, a brighter path forward is achievable if investments are coordinated, reach the frontline and are designed for long-term transformation.
