State Policy Updates

For updates on primary care-related actions by the administration and Congress, head to Federal Policy Updates.

For updates on efforts individual states are making to improve measurement and increase investment in primary care, visit the Primary Care Investment Efforts in States page. 

PCPCC Commends Delaware for Expanding the Membership of the State’s Primary Care Reform Collaborative

Delaware
August 8, 2019

The Patient-Centered Primary Care Collaborative (PCPCC) is pleased to report that Governor John Carny (D) signed Delaware Senate Bill 116  on August 7, 2019. 

This legislation expands the membership of the State’s Primary Care Reform Collaborative, creates the Office of Value-Based Health Care Delivery within the Department of Insurance, and compels the Collaborative to set a target for primary care investment by 2025

Delaware joins a growing number of states – Colorado, Oregon, Rhode Island, Vermont, Washington and West Virginia – who have passed legislation or enacted executive orders to report and/or set targets for investment into primary care.

“PCPCC is enthusiastic to see another state demonstrate its commitment to investing in primary care” said Ann Greiner, President and CEO, PCPCC, “The involvement of the Insurance Commissioner on the Primary Care Reform Collaborative gives that group added clout.  That said, we urge DE leaders to move more quickly in setting a target for primary care investment.  More investment in primary care can improve population health and help to reduce costs.”

The PCPCC is committed to working with more states on this vital issue and are gratified by the other states that passed legislation in 2019, including:

  • In Colorado, HB 19-1233, Investments in Primary Care to Reduce Health Costs sets targets for investment in primary care and establishes a state-run primary care payment reform collaborative.
  • In Vermont, S.53 will analyze spending with the intent of increasing the proportion of healthcare spending allocated to primary care.
  • In 2019, Washington state appropriated $110,000 for fiscal year 2020 that is provided solely for the office of financial management to determine annual primary care medical expenditures in Washington, by insurance carrier in total and as a percentage of total medical expenditure. 

“Governor Carny and the legislators from Delaware have taken a great step forward towards providing higher quality care for their constituents.”

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About the Patient-Centered Primary Care Collaborative
Founded in 2006, the Patient-Centered Primary Care Collaborative (PCPCC) is a not-for-profit, multi-stakeholder membership organization dedicated to advancing an effective and efficient health system built on a strong foundation of primary care and the patient-centered medical home. Representing a broad group of public and private organizations, PCPCC’s mission is to unify and engage diverse stakeholders in promoting policies and sharing best practices that support growth of high-performing primary care and achieve the “Quadruple Aim:” better care, better health, lower costs, and greater joy for clinicians and staff in delivery of care.

PCPCC Applauds Colorado and Vermont for Laws that will Measure and Increase Primary Care Investment

Colorado, Vermont
May 17, 2019

The Patient-Centered Primary Care Collaborative (PCPCC) applauds Colorado Governor Jared Polis and Vermont Governor Phil Scott for signing into law legislation in their respective states that will enhance primary care services and payment.

The separate bills approved by each state’s legislature have a similar goal: strengthening primary care access and capability in ways that will benefit all patients. Both bills align with PCPCC’s advocacy efforts to increase primary care investment in order to realize the kind of care envisioned by the Shared Principles, care that improves population health and helps to curbs costs.

Colorado and Vermont are part of a growing movement among states—Oregon, Delaware, and Rhode Island have already enacted changes – and proposals are being considered in several other states to drive more resources into primary care services.

“PCPCC is excited to see Colorado and Vermont join the ranks of states that have made primary care investment a top priority, and we look forward to working with other state leaders on similar initiatives,” said Ann Greiner, PCPCC President and CEO. “The bills that Govs. Polis and Scott have signed into law will transform their healthcare systems in ways that will better provide high-value, relationship-based care that keeps people healthy instead of waiting until they get sick. We are committed to begin and continue work with more states on these vital issues and applaud the leadership shown by Colorado and Vermont.”

In Colorado, HB 19-1233, Investments in Primary Care to Reduce Health Costs sets targets for investment in primary care and establishes a state-run primary care payment reform collaborative.

“We were pleased to see a diverse set of stakeholders come together in Colorado to support strong primary care in our state,” said John Cawley, MD Colorado Academy of Family Physicians President. “The legislation that Governor Polis has signed into law demonstrates that ensuring access to affordable, quality primary care services is a bipartisan priority for all Coloradans, one that voters, clinicians, hospitals, health plans, and other interested parties agree on.”

In Vermont, S.53 will analyze spending with the intent of increasing the proportion of healthcare spending allocated to primary care.

 “This is a significant step that builds on Vermont’s already extensive primary care infrastructure,” said Susan Barrett, Executive Director of the Green Mountain Care Board. “The legislation signed into law by Governor Scott aligns with the focus of the Green Mountain Care Board to increase access to primary care and reduce health care costs for all Vermonters.”

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About the Patient-Centered Primary Care Collaborative

Founded in 2006, the Patient-Centered Primary Care Collaborative (PCPCC) is a not-for-profit, multi-stakeholder membership organization dedicated to advancing an effective and efficient health system built on a strong foundation of primary care and the patient-centered medical home. Representing a broad group of public and private organizations, PCPCC’s mission is to unify and engage diverse stakeholders in promoting policies and sharing best practices that support growth of high-performing primary care and achieve the “Quadruple Aim:” better care, better health, lower costs, and greater joy for clinicians and staff in delivery of care.

 

PCPCC Applauds Delaware Report Recommending Increased Investment in Primary Care

Delaware
January 11, 2019
Washington, DC -- The Patient-Centered Primary Care Collaborative (PCPCC) applauds Delaware’s Primary Care Reform Collaborative (Collaborative) for its recommendations to invest more in primary care to meet the medical, behavioral, and social determinants of health of Delaware’s diverse patient population. These recommendations, if adopted, have the potential to help transform the health care system in Delaware and enhance value.

The Collaborative suggests the following recommendations:  
  • Delaware should incrementally increase primary care spending to eventually account for 12 percent of total health care spending.
  • The increase in primary care spending should include an upfront investment in infrastructure, increase the use of health information technology, support team-based care, and grow value-based incentive payments.
  • This mandate does not call for an increase in Delaware’s total health care spending and thus may result in constraints on increases for other health care costs.
  • Enforcement will occur through legislative statute or a regulatory enforcement authority, either in a new or existing agency.
  • The Collaborative will continue to work with stakeholders to enhance participation in value-based payment models, further initiatives to increase and sustain primary care workforce, and integrate Women’s Health and Behavioral Health within a primary care team model.
“The Collaborative's recommendations underscore Delaware's leadership in strengthening primary care,” said Ann Greiner, president and Chief Executive Officer of the PCPCC. “Research shows that advanced primary care reduces unnecessary specialist referrals, hospitalizations, and emergency room visits with better health outcomes for patients.”

“We know to improve health care in Delaware we must improve our system of primary care,” said Dr. Kara Odom Walker, Cabinet Secretary for the Delaware Department of Health and Social Services. “In order to strengthen our primary care workforce, we must invest in that care and find ways to incentivize front-line providers to perform as coordinated teams that are ultimately accountable for population health.”

The Collaborative consists of diverse state leaders and aims to develop annual recommendations to strengthen primary care in Delaware by collecting input from stakeholders in both the health care and patient communities, as well as from other model states. The Collaborative was created in August 2018 after Governor John Carney Jr. signed into law Senate Bill 227, legislation designed to strengthen primary care services and payment.
 
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The Patient-Centered Primary Care Collaborative
Founded in 2006, the Patient-Centered Primary Care Collaborative (PCPCC) is a not-for-profit multi-stakeholder membership organization dedicated to advancing an effective and efficient health system built on a strong foundation of primary care and the patient-centered medical home. Representing a broad group of public and private organizations, PCPCC’s mission is to unify and engage diverse stakeholders in promoting policies and sharing best practices that support growth of high-performing primary care and achieve the “Quadruple Aim”: better care, better health, lower costs, and greater joy for clinicians and staff in delivery of care.
 
PCPCC is and will position itself as an advocacy organization—a coalition that serves as a “driver of change,” educating and advocating for ideas, concepts, policies, and programs that advance the goals of high-performing primary care as the foundation of our health care system. For more information about PCPCC, visit www.pcpcc.org. 

For more information on nationwide primary care investment efforts, visit www.pcpcc.org/primary-care-investment. 

MEDIA CONTACT
Allison Gross
(202) 417-2075 
agross@pcpcc.org

PCPCC Applauds Delaware Law to Strengthen Primary Care

Delaware
August 29, 2018

For Immediate Release: CONTACT: Allison Gross; (202) 417-2075; agross@pcpcc.org 

Washington, DC (August 29, 2018) - The Patient-Centered Primary Care Collaborative (PCPCC) applauds Delaware Governor John Carney Jr. for signing into law Senate Bill 227, legislation designed to strengthen primary care services and payment.

SB 227 is directly in line with PCPCC’s legislative efforts to increase primary care investment in order to realize the kind of care envisioned by the Shared Principles. “Research shows that greater investment in primary care improves population health and helps to curb costs, said PCPCC’s President and Chief Executive Officer, Ann Greiner. “SB 227 pushes Delaware to the leading edge of healthcare reform and should serve as a beacon to primary care efforts nationwide.”

The law promotes the use of primary care through several approaches, including mandating that payers reimburse primary care physicians and other front-line practitioners for chronic care management and primary care at no less than the physician Medicare rate for the next three years; requiring payers to participate in the Delaware Health Care Claims Database; and creating the Primary Care Reform Collaborative (the Collaborative) under the Health Care Commission. The Collaborative will issue written recommendations by January 8, 2019, regarding appropriate levels of system-wide primary care investment, including an evaluation of whether 12% of health care spending should be directed to primary care and how primary care contributes to helping the state reach cost spending benchmarks. 

“As we change the way healthcare is paid for and delivered in Delaware, strengthening primary care is one of the most important pieces we need to address,” said Dr. Kara Odom Walker, Cabinet Secretary for the Delaware Department of Health and Social Services and a board-certified family physician. “Primary care is the foundation for promoting and delivering better health for all Delawareans and is critical in embracing value-based care – the idea that reimbursements are tied to providers’ success at keeping patients healthy.”

Delaware is the latest state to take action to strengthen primary care access and capability.  Leaders in Oregon and Rhode Island have already taken steps to drive additional resources to primary care in order to support the kind of care envisioned in PCPCC’s Shared Principles of Primary Care. Leaders in several states are working to enact similar changes, with progress in Colorado, California, and Vermont.

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About the Patient-Centered Primary Care Collaborative

Founded in 2006, the Patient-Centered Primary Care Collaborative (PCPCC) is a not-for-profit multi-stakeholder membership organization dedicated to advancing an effective and efficient health system built on a strong foundation of primary care and the patient-centered medical home. Representing a broad group of public and private organizations, PCPCC’s mission is to unify and engage diverse stakeholders in promoting policies and sharing best practices that support growth of high-performing primary care and achieve the “Quadruple Aim”: better care, better health, lower costs, and greater joy for clinicians and staff in delivery of care.

PCPCC Expresses its Concern with Proposed Funding Reduction to CMMI

District of Columbia
May 17, 2018

Dear Chairman Shelby, Vice Chairman Leahy, Chairman Frelinghuysen and Ranking Member Lowey: 
 
The Patient-Centered Primary Care Collaborative (PCPCC) writes to express its concern with proposed funding rescissions to the Centers for Medicare and Medicaid Innovation (CMMI) through the Spending Cuts to Expired and Unnecessary Programs Act, H.R. 3 under title X of the Congressional Budget and Impoundment Control Act of 1974.   The PCPCC strongly encourages Congress to address federal funding through the regular appropriations process and avoid the uncertainty about Congressional funding priorities caused by the rescission process.  
 
Founded in 2006, the PCPCC is a not-for-profit multi-stakeholder membership organization dedicated to advancing an effective and efficient health system built on a strong foundation of primary care and the patient-centered medical home. Representing a broad group of public and private organizations – including payers, healthcare clinicians and other providers, leading corporations and patient and consumer advocacy groups – the PCPCC’s mission is to unify and engage diverse stakeholders in promoting policies and sharing best practices that support growth of high-performing primary care to achieve the “Quadruple Aim”: better care, better health, lower costs, and greater joy for clinicians and staff in delivery of care. 
 
PCPCC strongly supports CMMI’s work to drive the shift to higher value healthcare, and we encourage you to maintain funding for the CMMI at the level previously stipulated by Congress.  CMMI funds are an important investment in transforming our healthcare system, and the potential savings from such investment can significantly strengthen our nation’s fiscal health.  
 
PCPCC urges Congress to continue to drive the Center for Medicare & Medicaid Services (CMS) to focus on the long-range vision of what our healthcare system should be and what 
individual steps are needed to achieve that vision.  We believe many promising efforts are underway at CMS, and we look forward to new, innovative models at CMMI under the leadership of Director Boehler.  

Leadership by CMMI is more important than ever as it races against time to find models that can maintain Medicare’s promise to our aging population and Medicaid’s commitment to those with the most need.  We need continued, aggressive innovation at CMS to ensure the bipartisan goals in the Medicare Access and CHIP Reauthorization Act (MACRA) are met in a way that meets patient needs and is feasible for clinicians to implement. 

CMMI must be allowed to get to strong quantitative outcomes on programs currently underway that are critical to the transformation of primary care – including the Comprehensive Primary Care Plus (CPC+) and Accountable Care models.  While outcomes have not yet fully materialized, there is a palpable system transformation happening under these programs that we have yet to fully realize and learn from.  From PCPCC’s review of the peer-reviewed literature, we know that care delivery transformation generally takes four-five years to achieve. We look forward to CMMI’s upcoming work on direct provider contracting, as we think there may be opportunity to strengthen primary care though these new models.  

Thank you for your time and attention to this request.  If you have any questions, please contact Chris Adamec, Director of Policy at cadamec@pcpcc.org or 202-640-1212. 

Sincerely, 
Ann Greiner President and CEO 

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