Bill > H2537

This bill establishes a comprehensive framework to improve primary care access and funding in Massachusetts by creating a Primary Care Board within the Health Policy Commission to study and strengthen the primary care system. The board will be composed of representatives from various healthcare organizations, government agencies, and professional associations, and will have broad responsibilities including defining primary care services, developing data reporting requirements, proposing payment models, and creating workforce development plans. A key provision is the introduction of an all-payer primary care capitation model, which would require health insurers to pay providers a prospective, per-member-per-month payment for primary care, with potential adjustments based on quality of care, advanced services, and patient complexity. The bill also sets progressive targets for primary care expenditures, starting at 8% of total healthcare expenditures in 2026 and increasing to 12% by 2028, with the goal of increasing investment in primary care, improving patient access, and supporting primary care providers. Additionally, the legislation includes provisions to ensure fair reimbursement for Federally Qualified Health Centers and mandates the creation of various reports and recommendations to continuously improve the primary care system in Massachusetts.

Health and Social Services

https://malegislature.gov/Bills/194/H2537