Bill > S867

This bill establishes a comprehensive primary care reform initiative in Massachusetts that aims to strengthen and support primary care services across the state. The bill creates a new Primary Care Board within the Health Policy Commission, composed of diverse stakeholders including healthcare professionals, government officials, and industry representatives, with the mission of studying and improving primary care access, delivery, and payment models. A key provision is the development of an all-payer primary care capitation model, which will require health insurers to pay providers a prospective, per-member-per-month payment for primary care services, with payments potentially adjusted based on the quality of care, advanced services provided, and the complexity of patient populations. The bill sets progressive targets for primary care expenditures, increasing from 8% of total healthcare spending in 2027 to 12% in 2029, and establishes a mechanism for health entities that fail to meet these targets to develop performance improvement plans. Additionally, the legislation includes provisions to ensure fair reimbursement for federally qualified health centers, support behavioral health urgent care services, and require detailed reporting and tracking of primary care expenditures. The bill represents a significant effort to prioritize and invest in primary care as a foundational component of the Massachusetts healthcare system.