top of page


"Imagine a construct – a “medical home” – as a house whose occupants are patients with a system of care constructed around them. This home is centered around the child or individual – of any age, ability, gender, race, ethnicity, sexual orientation, gender-identity – with solid walls strengthened by trust."

"Decades of ineffectual hand wringing over the primary care crisis underscores that state action is needed.  Even those who have not yet “come on board” know that this bill is a good blueprint for necessary reform. Just as it took government regulation to require manufacturers to install seat belts, this bill will provide “cover” for those who want to do the right thing but cannot do it alone."

"High quality Primary Care should be a sanctuary of trust, not a race against the clock. For the sanctity of Primary Care, for the very heart of our healthcare system to remain robust and vibrant, we must act decisively. We must allow Primary Care the flexibility to meet patients' needs beyond the confines of in-person visits. This flexibility includes asynchronous interactions and video visits, which can bring a ray of hope to both patients and providers alike."

"I could close the practice and go work in a country that values health care—I’ve been considering New Zealand—but then 8,000 patients wouldn’t have a doctor. They literally would NOT have a doctor because there are none-not a single primary care doctor, PA, nurse practitioner in the Pioneer Valley accepting new patients and we just lost another 8 doctors in the past year. Keep in mind that I truly care about all of these patients whom I have treated or 22 years –their wives, kids, grandparents, coworkers and future babies—who will have no medical care, here in the US!"

"A primary care doctor is her patient’s navigator through the healthcare world. We help new parents with their infants, help children grow into healthy adults, prevent heart attacks and strokes, catch cancer early when cure is possible, prevent falls and broken bones, deliver good news and bad, ease suffering, and bring comfort and peace to patients and loved ones at the end of life. We know which patient has the disease, not just which disease the patient has." 

"Over these past 20 years, primary care has been consistently called upon to expand treatment of opioid use disorder (OUD) with buprenorphine—the same treatment I saw in 2004 in South Boston. Except for certain exemplary practices throughout the Commonwealth, however, treatment of opioid use disorder in primary care has not been at all commensurate with the need. A major reason is that primary care is paid as though we do simple work when we are great at the complex care people actually need."

"I went from starting from scratch in solo practice to joining other solo family physicians to form a family practice group that grew to 10 doctors and 17 nurse practitioners in 3 locations at its peak. Focusing more on population health proved to be the right idea to meet goals, close gaps in care, and improve quality, but it all fell to us PCP’s to eliminate barriers by better outreach and support, very little of which was covered by fee-for-service reimbursement. And the underfunding and lack of access to mental health care also meant patients needed to depend on their PCP’s for that too, even when it required more than what we were trained to do."

"Our current Fee-for-Service healthcare model disincentivizes long-term, preventive care in favor of shorter patient visits and higher patient throughput. This archaic system disproportionately disadvantages primary care practices, depriving patients of essential healthcare services. Senate Bill 0750 proposes a paradigm shift by introducing a more equitable and effective mechanism for financing primary care services, specifically through prospective payments.

Senate Bill 0750 is not merely a healthcare model; it is a veritable beacon for a healthcare system that aspires to be equitable, comprehensive, and sustainable."

"S.750 will also improve the efficiency of health care. It’s not well understood that too often, medical decision making is driven by the pressure of time and unfamiliarity with the patient. For patients, a trip to the emergency room is perfectly rational when there is no alternative, and hospitalizations that are of borderline necessity can often occur when there is no PCP to manage things on the outside. This drives up costs. When the clinician and patient know each other well, tremendous efficiency is achieved. This is a paradox – unlike in factories, in health care, the more time that is spent with the patient, the more efficient care can become. Continuous, relationship-based care is critical for avoiding overdiagnosis or overtreatment."

"Due to my family’s medical debt, I spent much of my teenage years food-insecure, and my family could not afford continuous, preventive medical care. When a family member required medical attention, we often would not seek it: My mother could not afford the lost wages and gas money required to take time off from work and visit the PCP. Instead, we tried to “sleep it off,” no matter how sick we were. My then nine-year-old sister and I, who were acutely aware of our family’s financial struggles and the stress they caused, would often pretend to not be sick in order not to burden the family. With a lot of hard work and a lot of luck, my family has been able to climb out of poverty over the course of a couple decades."

"Employers who are major purchasers of healthcare want their employees to have access to high quality Primary Care. Access to Primary Care means employers can avoid being out of work due to illness and unnecessary spending associated with worsening of chronic disease, unnecessary trips to the Emergency Department, unnecessary hospitalizations, etc. Investment in high quality Primary Care through PC4You generates happy employees. Employers will be pleased with the unfettered access to primary care that PC4You offers their employees (no cost sharing: no copays, no deductibles)."

"This increase in longevity extends to all those with access to [primary] care. Improving the way we provide primary care with PC4You is one of the many important ways of addressing systemic racism in the US and dismantling the structural inequities that healthcare continues to perpetuate. The life expectancy of white individuals still exceeds their black counterparts by 5 years as of 2020, and this gradient continues to increase as we see the ramifications of the COVID-19 pandemic exacerbating this issue.  Increasing investment in primary care will distribute the benefits of increased longevity and improved overall health to populations historically marginalized in medicine which will begin to close the gap in life expectancy."

"One of the most concerning aspects of physician burnout is its potential impact on patient safety. Extensive evidence indicates that burnout can lead to decreased productivity, compromised quality of care, and an increased likelihood of diagnostic errors. The emotional exhaustion and depersonalization experienced by burnt-out physicians can diminish their capacity to form meaningful connections with patients, resulting in suboptimal care delivery. The World Health Organization has estimated that 4 out of 10 patients have been harmed in primary care settings with a driving force being physician burnout and well-being."

"The biggest challenges to primary care investments include the lack of strong and consistent value-based financial incentives. However, with its per member, per month prospective payment model, PC4You prioritizes value payments and can save billions of dollars in healthcare spending while improving the health and well-being of individuals and communities. The evidence is clear – primary care is a powerful tool in our quest for affordable, high-quality healthcare. Primary care is also a lever for reducing health inequities which translates to $5.8 billion of cost savings annually."

"The 17 transformers included in the PC4You bill address the buckets of patient access, mental/behavioral health care, collaboration and team-based care, lifestyle modification and care for the medically vulnerable and elders. They are presented as a menu of options, allowing each practice to select those that are most applicable to them and their patient population. The payment schematic for the transformers results in the additional investment in primary care to directly enable and support evidence-based activities tailored to individual communities and practices that will decrease health inequities, improve health, decrease cost and improve the experience of both patients and clinicians." 

"My participation in the group wellness programs allowed me to get to know most all the doctors, PAs, MAs and administrative personnel to a greater depth and breadth than any other medical practice with which I have been a patient… and they with me. So, I wasn’t totally shocked when I was approached about becoming a ‘patient advisory member’ of their Quality Improvement Team. [I got] a transformative experience: It’s like seeing the entire “iceberg” vs just what is visible above the water (which was how it was at the primary care practices that served me in the past)."

bottom of page