Massachusetts Health Policy Commission

This document outlines the Massachusetts Primary Care Access, Delivery, and Payment Task Force's recommendations for establishing a primary care spending target for private and public health care payers. The core recommendation is to increase primary care spending to either double the current share or 15% of total healthcare spending, whichever is greater, within five years from a 2026 baseline. Key strategic areas include ensuring health care affordability, designating the Massachusetts Health Policy Commission (HPC) and the Center for Health Information Analysis (CHIA) for oversight and measurement, prioritizing payment and care delivery reforms that support person-centered primary care, and establishing robust accountability mechanisms. The ultimate vision is for Massachusetts to become a national leader in rebalancing its health care system, ensuring sustainable primary care, supporting the workforce, and delivering accessible, efficient, effective, and equitable care.

This document outlines the recommendations of the Massachusetts Primary Care Access, Delivery, and Payment Task Force (PCTF) for establishing a primary care spending target in the Commonwealth. The central recommendation is to set an aggregate primary care spending target aiming to either double the share of health care spending on primary care or reach 15%, whichever is greater, within five years from the 2026 baseline. The plan emphasizes ensuring health care affordability without increasing overall expenditure trends or premiums, designates the Massachusetts Health Policy Commission (HPC) and Center for Health Information Analysis (CHIA) for oversight and accountability, and advocates for payment and care delivery reforms. The overarching vision is to rebalance the health care system to prioritize sustainable primary care, strengthen the workforce, and deliver more accessible, efficient, effective, and equitable care.

The task force conducted its final scheduled in-person meeting to reflect on its progress and discuss key deliverables, specifically focusing on monitoring and tracking the needs of service delivery for the Commonwealth. Discussions covered the state's capacity to assess primary care needs, the importance of data assets for measuring provider capacity, patient panel sizes, and wait times. Members provided feedback on refining wait time metrics, including nuances for routine versus urgent care, and emphasized the need to capture data on different practice models such as concierge, direct primary care, and NP-owned practices. The board also discussed potential gaps in data regarding patients who are currently disenfranchised from the health care system.

The agenda includes discussions on market transactions, specifically material change notices and a final report regarding the Mass General Brigham and CVS Health MinuteClinic Primary Care Cost and Market Impact Review. The meeting will also cover health care transformation and innovation, focusing on the status of investment programs and key findings from the evaluation of the C4SEN investment program. The meeting will conclude with an Executive Director's report and an executive session.

The workgroup focused on identifying sources of provider burnout to inform the development of workforce development plans. Key topics included the administrative burden of prior authorization, high patient volumes, and the constraints of fee-for-service payment models. The group discussed inefficiencies in referral processes, the need for streamlined credentialing, and the potential for artificial intelligence to reduce administrative tasks in electronic health record systems. Additionally, discussions covered improving health information exchange, simplifying licensure across state borders, and optimizing immunization information system reporting.