“This report is a three-alarm fire,” said Ann Greiner, PCC’s President and CEO. “The primary care platform was shrinking—and then the pandemic hit. Primary care practices were slammed financially and did their best to respond to patients’ needs, but they have been hamstrung. Patients, particularly those in vulnerable and marginalized communities, are the collateral damage.”

The report is the second consecutive year that the PCC has reported primary care spending nationally and at the state level. The report also confirms an association between higher primary care spending at the state level and fewer emergency department visits, hospitalizations, and preventable hospitalizations, documented in the PCC’s 2019 research report.


A section of the report provides updates on state governments’ actions toward increasing their investments in primary care in 2019 and 2020. To date, 12 states have reported or committed to report primary care spending, and some states are setting spending targets for primary care, according to the report.

To develop the report, the PCC used data from FAIR Health on healthcare claims for persons of all ages enrolled in private insurance plans (both fully insured and self-insured), including employer-sponsored, individual and Medicare Advantage plans, in all 50 states. The PCC uses the definition of primary care spending of the percentage of total annual spending on medical care services and prescription drugs that is spent on primary care services. And generally accepted narrow and broad definitions of primary care clinicians and services—what they encompass—are used in the report.


Darilyn Moyer, MD, FACP, FRCP, FIDSA, chair of the PCC’s board of directors and Executive Vice President and CEO of the American College of Physicians
Ann Greiner, Primary Care Collaborative President and CEO
Ann Kempski, Advisor, Primary Care Collaborative

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