This episode of Quality Matters examines primary care’s evolving role and features Karen Johnson of the American Academy of Family Physicians and Jeff Sitko of NCQA. 

Karen and Jeff outline primary care’s distinguishing focus on patient relationships, the strain on the primary care workforce, and technology’s promise to ease burdens. The discussion connects the dots between workforce sustainability, AI-driven efficiency, payment reform, and NCQA’s vision for next-generation primary care.

Karen highlights the underappreciated fact that only 5% of health care spending goes to primary care, despite public perception that the figure is—and should be—higher. Jeff describes a dawning era of proactive, data-driven care delivery. He also previews NCQA’s plans to build upon the successful Patient-Centered Medical Home model of primary care.

Highlights

• The Human Core of Primary Care: Continuity and trust are what make primary care special, even as practice settings change.
• Workforce Challenges and Opportunities: Clinicians report high stress and burnout, yet relationships with patients keep them engaged. Building systems that protect these relationships—and make primary care careers attractive—is critical to sustainability.
• Economics and Incentives: Guests discuss new payment models, state-level initiatives and federal efforts to rebalance incentives and support primary care in new ways.
• Looking Ahead: The foundational Patient-Centered Medical Home model gets an update in 2026. Plus, Karen calls for a seismic shift to resource primary care as a common good.

This episode is essential listening for healthcare executives, policymakers, and clinicians committed to strengthening primary care as the cornerstone of quality improvement.

Key Quote:

If you want to boil it down to the simplest terms, it's taking primary care from a reactive model—Call me when you're sick; I'll put you on my schedule; Come in and see me—to a proactive model.

I am paying attention to a population of patients. They're mine. They're on my panel. And now maybe they're also tied to some accountability arrangement in value-based care, where performance comes into play.

And so I'm going to be proactive for a lot of reasons. One, it's the right thing to do for patients. But I also want to make sure my patients are getting preventive services they need, they are taking the medications I prescribe, they are going to the referral I recommended. And I'm getting the information back from that physician, and my team is acting on that. It's all of those things that should be ubiquitous in primary care.

-Karen Johnson, PhD

Time Stamps:

(01:07) The Changing Landscape of Primary Care

(06:42) Challenges in the Primary Care Workforce

(08:49) How Technology is Impacting Primary Care

(15:59) Future Directions and Innovations

(18:11) NCQA's Plans for 2026

Dive Deeper:

State of the Primary Care Workforce 2024 (HRSA)

The Pulse of Primary Care (JGIM)

Connect with Karen Johnson

Connect with Jeff Sitko

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