02.27.2025 / Press Release

During Health Care Value Week, Families USA Releases Analyses with Recommendations to Reform America’s Flawed Health Care Payment System

WASHINGTON, D.C – Families USA has published two new analyses on how we can improve our nation’s health care system to provide better quality, lower cost care. The Nuts and Bolts of Medicare Physician Payment — And Why It Needs Reform and Lay of the Land: Primary Care, Provider Payments and What’s Next provide primers for policymakers and advocates on how to reorient the economic incentives of physician payment to build a more sustainable system that will make our nation’s families healthier.

These reports come in the middle of Health Care Value Week, and ongoing discussions to improve the health system. At the same time, these careful and commonsense proposals come in contrast to the House Republicans passing a budget resolution requiring more than $800 billion in cuts, mostly to Medicaid, which would upend the health care system we all rely on.

“We need to bring higher quality care to more people at a price they can afford, and invest more in primary care for better health outcomes. Health Care Value Week is spotlighting several solutions for our broken health care system where many Americans feel they are paying too much out-of-pocket for sub-par care and coverage. While there are bipartisan, well-vetted policy solutions ready to be enacted to improve our health care system, none of them involve cutting $880 billion from Medicaid, ripping health care coverage away from millions of people, and forcing states to scale back or eliminate health care services we all need and use, as House Republicans just voted to do this week,” said Sophia Tripoli, a primary author of both publications and senior director of health policy at Families USA. “Make no mistake, if the budget that House Republicans approved goes through, primary care in this country will be decimated and providers and state governments will bear the burden of skyrocketing uncompensated care costs. Instead, we need to advance solutions that will ensure quality care and improving overall health are prioritized, while also making sure millions of Americans don’t go bankrupt over a medical bill they can’t afford.”

Last week, a new report on our nation’s primary care crisis, developed by researchers at the Robert Graham Center for Policy Studies in Primary Care and co-funded by the Milbank Memorial Fund and The Physicians Foundation, cites historic underinvestment and over-reliance of the broken financial incentives as major drivers of primary care workforce shortages and reduced patient access to vital services. Families USA’s latest publication builds on that report to identify policy solutions that will take significant steps forward in curbing this crisis by adequately investing in primary care to ensure all people living in America can get high quality, affordable health care that prevents illness, allows them to see a doctor when needed, and helps keep their families healthy.

The analyses emphasize how the current U.S. health care payment systems impact care quality — incentivizing costly procedures that will make providers more money, while underrating crucial services like care coordination and primary care, that are proven to keep people healthier. They also shine a light on key opportunities for policymakers to make meaningful improvements to the health care system by changing financial incentives and creating greater accountability for health care outcomes and costs.