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- Howard Mark Haft and Robert Berenson.
- Maryland Department of Health, Baltimore, MD, USA. hhaft@aol.com.
- J Gen Intern Med. 2023 May 1; 38 (7): 174717501747-1750.
AbstractThe delivery of primary healthcare in the USA is threatened on multiple fronts. To preserve and strengthen this critical part of the healthcare delivery system, a rapid and broadly accepted change in the basic payment strategy is needed. This paper describes the changes in the delivery of primary health services that demand additional population-based funding and the need to provide sufficient funding to sustain direct provider-patient interaction. We additionally describe the merits of a hybrid payment model that continues to include some level of fee-for-service payment and point to the pitfalls of imposing substantial financial risk on primary care practices, particularly small- and medium-sized primary care practices lacking the financial reserves to sustain monetary losses.© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.
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