Primary care is in crisis, and it's time to face the hard truth: our healthcare system is failing its foundation. But could doubling spending on primary care be the bold move we need?
In a groundbreaking effort, state officials have launched a 25-person task force to tackle this issue head-on. Their mission? To reevaluate reimbursement rates, address workforce shortages, and set a clear target for how much insurers should invest in primary care. And this is the part most people miss: the task force's initial proposal is nothing short of revolutionary—doubling the state's primary care spending to 15 percent within five years. To put this in perspective, Massachusetts currently spends just 6.7 percent of its healthcare dollars on primary care, far below the 14 percent average in other high-income nations.
David Seltz, executive director of the state’s Health Policy Commission, frames this as a rebalancing act: "This recommendation prioritizes the health of our residents and the stability of our world-class healthcare system." But here's where it gets controversial: while the vision is grand, the details are scarce. The task force insists that this increased investment shouldn’t inflate overall healthcare spending or premiums—a claim that has skeptics raising eyebrows. How exactly will this be achieved? The proposal hints at administrative efficiencies or reallocating funds, but specifics are lacking.
To give this plan teeth, the task force is urging the Legislature to pass a bill setting the new spending target. If successful, the Health Policy Commission and the Division of Insurance could hold payers and providers accountable. After the initial five-year period, the commission would set new targets annually. But is this feasible without cutting corners elsewhere? Some worry that diverting funds to primary care could starve innovative care models that reduce emergency visits and hospital admissions.
This isn’t Massachusetts’s first rodeo. In 2020, then-Governor Charlie Baker pushed for a similar doubling of spending on primary and mental health care, but the plan was sidelined by the COVID-19 pandemic. Since then, access to primary care has only worsened. A 2025 report revealed that new patients in Boston wait an average of 40 days for an appointment—twice as long as in other major cities. Patients are increasingly turning to emergency departments as a last resort.
Here’s the kicker: despite having the highest number of physicians per capita, Massachusetts ranks fifth lowest in primary care doctors. And the workforce is aging, with half of primary care physicians over 55. Lora Pellegrini, CEO of the Massachusetts Association of Health Plans, emphasizes that success hinges on health systems’ cooperation. Nationally, nearly half of primary care physicians are affiliated with hospitals, which have historically resisted increased spending in this area.
Not everyone is sold. Eric Dickson, CEO of UMass Memorial Health, questions the proposal’s practicality: "It’s hard to imagine doubling primary care spending without driving up overall healthcare costs." He also fears this mandate could stifle investment in proven innovative care models.
Yet, the proposal has garnered enthusiastic support from a diverse group of stakeholders, including Dr. Kiame Mahaniah, the state’s health and human services secretary, and Ashley Blackburn from Health Care For All, who calls it "timely and important." But what do you think? Is doubling primary care spending the solution, or is this plan too ambitious? Could it inadvertently harm other critical areas of healthcare? Let’s spark a conversation—share your thoughts in the comments below.
