Our Recent Work

The COVID-19 pandemic has underscored that primary care payment reform is urgent and necessary. Fee-for-service payments limit flexibility in how practices can respond to crises and how care is delivered in general. As payers and policymakers look toward prospective payments to augment or replace fee-for-service payments, there is a need for more information on how best to design these systems.
This article reviews several sources of evidence, including studies on primary care spend as a percentage of the total cost of care, studies of “breakeven” rates, and direct primary care rates to estimate the range of amounts needed in global primary care payments. Finally, the article covers key implementation considerations for prospective payments.