Federal Investment in Primary Care Transformation

What are the myriad outcomes of the multifaceted federal programs to change primary care delivery from 2010 to 2021?In this systematic review of 142 records, programs supported practice-level changes in care delivery through payment changes, performance requirements, data feedback, and technical assistance, while federal investments were associated with substantial improvements in clinical care delivery, greater patient engagement, modest reductions in utilization, and net increases in expenditures. However, common measured outcomes were variable, with external factors possibly limiting impact.Ten years of federal programs to transform primary care provides useful lessons for practices, program implementers, and policymakers.

Corresponding Author: Laura L. Sessums JD, MD, American Board of Internal Medicine, 510 Walnut St, Ste 1700, Philadelphia, PA 19106 (lsessums@abim.org).

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