The Primary Care Common Fund

The Primary Care Common Fund (PCCF) is a new approach to financing primary care that treats it as an essential public good, much like education, fire, or police. Rather than having dozens of public and private insurers independently finance and pay for primary care, a state establishes a common fund that pools existing primary care resources from multiple purchasers and distributes payments directly to primary care practices. The PCCF advances universal primary care through a multi-payer, single-administrator model. By creating a more unified, predictable, and sustainable funding stream, the PCCF offers several important advantages: it can expand access to primary care regardless of patients' insurance status or changes in coverage; reduce administrative complexity and billing burdens for practices; ensure that primary care resources reach the clinicians and communities providing care; and enable more flexible, innovative payment models that reward comprehensive, continuous, high-quality care rather than simply the volume of visits. Because the PCCF operates through a state-administered financing structure rather than direct regulation of health insurance plans, it can encompass both fully insured and self-insured populations, avoiding the limitations imposed by ERISA. Importantly, the model allows states to strengthen and stabilize primary care without fundamentally changing how the rest of the healthcare system is financed or delivered. Ultimately, the PCCF offers states a practical pathway to reverse decades of underinvestment, strengthen the primary care workforce, and build a more accessible, equitable, and sustainable health care system.