Press Release: 12/16/2025

State Task Force Recommends Rebalancing Health Care Spending to Support Primary Care

 



Task Force recommends significantly increasing primary care investment through a new spending target of at least 15%



BOSTON — The Massachusetts Primary Care Access, Delivery, and Payment Task Force (PCTF), co-chaired by the Massachusetts Health Policy Commission and Executive Office of Health and Human Services, today called for the Commonwealth to significantly increase investment in primary care through a primary care spending target(opens in a new tab).



Despite clear evidence that access to and appropriate utilization of primary care improves outcomes and reduces overall costs, the United States spends only 5 to 7% of total health care dollars on primary care -- far below the average of 14% in other high-income countries -- and Massachusetts’ primary care spending comprised only 6.7% of total commercial health care spending in 2023.



To spur a necessary shift of health care dollars, the PCTF recommends that the Commonwealth adopt a bold statewide primary care spending target in its third statutory deliverable. This recommendation details that the Legislature should establish an aggregate primary care spending target equal to 15% or double the current primary care spending share, whichever is greater, within five years of the 2026 baseline, with annual measurable improvement.



Further, the task force emphasized that increased investment in primary care must not raise overall health care cost growth or lead to new premium or cost-sharing increases. To ensure this, the recommendation calls for strong oversight and enforcement by the HPC, the Division of Insurance (DOI), and the Center for Health Information and Analysis (CHIA).



Under the proposal:




  • The HPC will set annual improvement targets, monitor payer and provider performance, and enforce compliance through performance improvement plans and potential penalties.

  • CHIA will measure statewide baseline spending starting in 2026 and expand reporting to include age-specific primary care spending trends, including pediatric care.

  • State agencies will use newly strengthened data systems to ensure additional primary care spending directly supports frontline practices, including those within larger health systems.



The PCTF’s forthcoming recommendations on payment and care delivery reform and workforce development will further outline strategies to strengthen and sustain the primary care system. If enacted by the Legislature, these recommendations would position Massachusetts as a national leader in rebalancing health care spending to prioritize accessible, equitable, and high-quality primary care.



Statements of Support from Primary Care Task Force Members:



“In Massachusetts, we have an outstanding health care system for treating those who are sick. What we don’t have across our country at this point is a system that collectively works well to keep people healthy. These spending targets are an important tool to better align our health care spending with our values. Investments in primary care will not only yield future health care costs savings, but hold immeasurable value in the quality of life for our residents that comes with staying healthy.”

Task Force Co-chair Kiame Mahaniah, MD, MBA

Secretary of Health and Human Services, Massachusetts Executive Office of Health and Human Services



“This recommendation is the first step towards a fundamental rebalancing of what we value in our health care system, putting the health of our residents and the stability of our world-class health care system first. Establishing a primary care spending target while addressing complementary goals related to workforce and patient care will strengthen primary care in the Commonwealth and pave the way for more affordable, equitable, and accessible health care for all of our residents.”

Task Force Co-chair David Seltz

Executive Director, Massachusetts Health Policy Commission



"Establishing a spending target is a critical first step in creating a primary care system that is both successful and sustainable. And given that you can't measure what you don't know, setting a baseline spend stemming from detailed and uniform data from all payers and providers will allow us to actually and accurately measure progress in reaching the target. I'm extremely proud of the Task Force and it's work to develop these recommendations."

Senator Cindy Friedman

Chair, Joint Committee on Health Care Financing



“Primary care is the foundation of a healthy community, and too many families in the Commonwealth struggle to find and keep a primary care provider. The Task Force’s recommendations on the statewide spending target highlight both the urgency of the problem and the opportunity to improve primary care in Massachusetts. Any new investment must be evidence-based and translate to real improvements for patients by delivering equitable access, shorter wait times, stronger patient-provider relationships and culturally competent care. If we get this spending target right, we will create a stronger and more sustainable primary care system.”

Representative John Lawn

Chair, Joint Committee on Health Care Financing



"Massachusetts patients will benefit from a new spending target which will increase our focus on primary care and affordability for all."

Michael Caljouw, JD

Massachusetts Commissioner of Insurance



“CHIA’s analysis of primary care spending has consistently underscored the need for system-wide investment in these foundational services. A high-functioning primary care system leads to better patient outcomes, lower costs, and more equitable care. Setting a spending target is a signal that Massachusetts is serious about its goal to prioritize that investment.”

Lauren Peters, JD

Executive Director, Center for Health Information and Analysis



“Investing in primary care is investing in the health and well-being of communities across Massachusetts. The task force recommendations reflect MassHealth’s continued commitment to growing our own spend in primary care in the coming years, and we look forward to working with payers and providers throughout the Commonwealth to improve primary care for all residents.”

Ryan Schwarz, MD, MBA

Chief, Office of Accountable Care and Behavioral Health, MassHealth



Explore the full primary care spending target recommendation and more information on the PCTF on the HPC’s website.