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In December 2025, a Massachusetts task force called for the Commonwealth to significantly increase investment in primary care through a primary care spending target of at least 15 percent.
In Massachusetts, primary care spending as a percentage of all commercial healthcare spending was 6.7% in 2023, and is declining, according to a report from the Massachusetts Primary Care Access, Delivery, and Payment Task Force (PCTF).
Other states have passed legislation to increase the proportion of total healthcare spending directed to primary care. In 2024, California’s Office of Health Care Affordability set a goal of increasing primary care spending to 15% of total medical expenditures by 2034. In 2017, Oregon set a primary care expenditure target of at least 12% for all payers to by reached by 2023. Though this benchmark is not enforceable, the Oregon Health authority can require carriers that do not reach the target to submit a plan to increase spending on payment for primary care as a percentage a percentage of total health expenditures by at least one percent each plan year. In 2024, Rhode Island set a new primary care spending target of 10%, effective 2025.
The PCTF’s recommendation is that the Massachusetts Legislature should establish an aggregate primary care spending target for the Commonwealth that is equivalent to either (1) doubling the share of healthcare spending on primary care as a percentage of total healthcare spending or (2) 15%, whichever is greater, within five years from the base-line year 2026, with improvement measured annually.
The task force added that the Legislature should ensure that any increase in primary care spending should not result in an increase in the growth of overall health care expenditure trends or to a net new increase in health insurance premiums and cost-sharing and should authorize the Massachusetts Health Policy Commission (HPC) and the Division of Insurance (DOI) to hold payers and providers accountable for any such increases.
Several task force members issued statements explaining their support for the proposal.
“In Massachusetts, we have an outstanding healthcare 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,” said Kiame Mahaniah, M.D., M.B.A., Secretary of Health and Human Services, Massachusetts Executive Office of Health and Human Services. “These spending targets are an important tool to better align our healthcare spending with our values. Investments in primary care will not only yield future healthcare costs savings, but hold immeasurable value in the quality of life for our residents that comes with staying healthy.”
“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,” said Ryan Schwarz, M.D., M.B.A., chief, Office of Accountable Care and Behavioral Health for MassHealth, the Commonwealth’s Medicaid program.
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