In an Unprecedented Move, Seven National Primary Care Organizations Launch Joint Vision to Rewire Primary Care Financing

With COVID-19 as a catalyst, the organizations developed recommendations to fundamentally change the way primary care is financed, improve health equity and boost clinicians’ ability to offer seamlessly integrated care

Richmond, Va., (December 22, 2020) – Seven of the nation’s largest primary care physician organizations today released recommendations on the urgent need to change the way primary care is delivered and financed. The American Academy of Family Physicians, the American Academy of Pediatrics, the American Board of Family Medicine, the American Board of Internal Medicine, the American Board of Pediatrics, the American College of Physicians, and the Society of General Internal Medicine represent more than 400,000 physicians and have created a unified vision to change the conversation and modernize primary care as we know it.

This collaborative work comes at a critical time when the health of the population has weakened, and the primary care setting has been severely strained by COVID-19. Handling nearly 40 percent of all health care visits, primary care clinicians have made incredible adaptations to continue to provide care during the pandemic, yet they have been largely left out of national pandemic relief legislation. A series of clinician surveys conducted during the pandemic has shown widespread closures and layoffs among primary care practices despite the critical role these practices and clinicians play in pandemic recovery efforts.

“Primary care physicians cannot adequately meet the needs of their communities if they remain shackled to payment schemes which reimburse for volume instead of value,” said John Brady, MD, Chair of the American Board of Family Medicine. “Many current regulatory demands unnecessarily distract clinicians from patient care. Coming out of the pandemic, a return to the status quo is not sufficient. The American public deserves better.”

These seven national organizations developed specific recommendations to advance primary care as a public good, shift the model of financing primary care and dismantle the regulatory and financing structures that interfere with optimal individual and population health. The unified vision includes a shift from cost-based attributes of the current model (sick care, organized around episodic, transactional, and fragmented care delivery) to a model grounded in health equity and investment – with attributes based in health and organized around longitudinal, relational and integrated care delivery.

“Primary care provides patients of all ages with the care they need to be healthy. In pediatrics, it means ensuring children can receive critical services, like immunizations, that promote their lifelong health and development,” said Sally Goza, MD, FAAP, President of the American Academy of Pediatrics. “We must ensure that our primary care infrastructure is strong and well supported if we are to assure the health of Americans across their lifespan.”

In an open letter to policy makers, payers, purchasers and the public, the seven organizations call on: 

  • The federal government to increase investment in safety net programs, public health agencies and community-based services and support so that they may partner with the medical care sector in addressing structural racism and social drivers of health.
  • Health care organizations to invest in existing community-based social services and ensure that the flow of dollars supports services such as food banks and other safety net programs that address social drivers of health.
  • Fellow physician and clinician societies to create a roadmap for dismantling the policies and regulatory structures that enshrine the current paradigm, and to build multi-stakeholder support for a roadmap.

The collaboration was convened by the Larry A. Green Center and facilitated by X4 Health as part of their continuing effort to change the conversations around primary care in support of improved health for all Americans and the strengthening of primary care.

“Never have these seven physician societies and their boards worked together in this way,” said Rebecca Etz, PhD, co-director of The Larry A. Green Center and associate professor, Department of Family Medicine & Population Health at VCU. “Before COVID-19, our healthcare system was already failing us. We have a new opportunity today to protect primary care and ensure it is there for us both now and long after COVID-19. Our team at the Larry Green Center is extremely proud to work with X4 Health in enabling this work.” 

More information about any of these organizations and the new vision for primary care finance can be found at


The seven national primary care physician organizations:

Staffed by:

The Larry A. Green Center (convener):
The Larry A. Green Center works to reclaim and reconstitute the intellectual foundations of primary care, to advance the science of primary care, and to deliver on a decades old promise: better health, improved health care, and a synergistic focus on both humanism and healing.

X4 Health (facilitator):
X4 Health is a purpose-driven organization specializing in social impact design, solving problems that matter in health care with passion and precision. Learn more at