5 Ideas to Shape the Future of Primary Care

Turning insights from the Milbank 2025 Scorecard into action

Primary care has long been heralded as the cornerstone of a strong healthcare system—improving outcomes, reducing costs, and driving equity. Yet in the U.S., this cornerstone is cracking. According to the Milbank Memorial Fund’s 2025 Scorecard, we continue to chronically underinvest in primary care. The result? Diminished access, alarming burnout among clinicians, and a system ill-equipped to deliver on its potential.

But we don’t have to stay on this path. If we listen to the Scorecard not just as a diagnosis—but as a call to action—we can reimagine what primary care can be. At Elation Health, we’re privileged to partner with practices that are already leading this transformation. From rethinking workforce models to leveraging clinical-first technology, they’re proving that a better future is within reach.

Here are five bold yet achievable ideas to help shape that future—grounded in the findings of the Scorecard and brought to life by the primary care clinicians we serve.

1. Primary Care Should Finally Get the Investment It Deserves

The Milbank Scorecard opens with a stark truth: “Primary care in the United States is underfunded.” On average, only 5–7% of total health spending goes to primary care—compared to nearly double that in countries with more equitable and effective systems.

This imbalance isn’t just a budgeting issue; it’s a misalignment of priorities. We reward reactive interventions instead of proactive care. We compensate procedures more than relationships. Let’s shift that balance. Policymakers, payers, and health systems must commit to increasing primary care spending—to at least 10% of total health expenditures—and structure payment models that incentivize continuity, prevention, and whole-person care.

The practices Elation supports often do more with less. Imagine what they could achieve with the investment they truly deserve: more team members, more time with patients, more room to innovate. We’ve seen firsthand how even modest increases in funding can drive major gains in quality and access. According to the Scorecard: “state and federal efforts to track and increase primary care investment should be expanded and accelerated.” We agree—and we’re ready to support practices and their patients who would benefit from this kind of investment.

2. Tackle the Workforce Shortage with a Multifaceted Strategy

The Scorecard highlights an uncomfortable reality: over half of U.S. counties are designated primary care health professional shortage areas. And the number is rising. Between clinician burnout, medical school specialization trends, and geographic maldistribution, we’re facing a crisis in access—particularly in rural and underserved communities.

While Milbank’s report emphasizes the shortage, it also points to solutions. No single intervention will solve this crisis. It will require a systemic approach. That’s why we need to address the workforce shortage on multiple fronts:

• Diversify the care team by empowering advanced practice providers, behavioral health specialists, and pharmacists to take on more responsibility within physician-led primary care teams.
  

• Open doors for internationally trained physicians, many of whom face barriers despite being ready and able to serve.
  

• Use technology to extend capacity, reducing clinician workload while maintaining quality and personalization.
  

• Incentivize primary care careers through loan forgiveness, flexible care models, and real paths to sustainable practice ownership.
  

A workforce strategy is a care access strategy. When primary care clinicians can focus on care—and when they aren’t alone in delivering it—patients benefit, communities thrive, and clinicians are more likely to stay in the field long-term. This also means that access to high-quality primary care can be more equitably distributed.

3. Prepare Clinicians for the Business Side of Care

The Scorecard details how many independent practices, especially in under-resourced areas, face barriers to financial sustainability. But it doesn’t just come down to payer rates or administrative bloat—it’s also about preparedness.

Most physicians don’t graduate medical school with training on how to manage a P&L statement, negotiate contracts, or build a billing workflow. Yet they’re expected to run businesses that are often their community’s only healthcare lifeline.

Instead, we could integrate business and leadership training into both medical education and continuing education. We need to empower clinicians with the skills to not only to care for patients—but also to lead, grow, and sustain their practices. A strong operational foundation is essential for independent practices to thrive, enabling community-rooted decision-making and greater satisfaction for both patients and clinicians.

By equipping physicians with business and leadership skills, we can help them build resilient, mission-driven practices that truly reflect the needs of their communities. If we want to expand access to primary care, we must invest in the people leading it. That means training clinicians not just as caregivers—but also as entrepreneurs.

Want a practical primer? Explore our Business of Medicine eBook for insights into financial management, operations, and growth for independent primary care.

4. Technology as a Force Multiplier—Not a Burden

The Scorecard flags clinician burnout as a major barrier to sustainable care—and many clinicians will tell you: their EHR is part of the problem. Legacy technology often slows workflows, adds documentation burden, and detracts from the patient relationship.

But technology doesn’t have to be the enemy of good care. In fact, when built right, it’s one of the most powerful tools we have. Many tools have overlooked what makes primary care work: human connection, continuity, and efficiency. This means primary care needs to adopt platforms that serve as true partners to the clinician—amplifying their time, streamlining administrative work, and enhancing care decisions.

Elation’s AI-powered EHR lightens the documentation load—so you can spend less time charting, and more time caring. See how it works. 

Technology should lift clinicians up, not weigh them down. When technology aligns with workflows and values, it saves time, reduces errors, and gives clinicians more time to focus on what matters most—care.

5.  A Reimagined Access Model for Patients—and Clinicians

Patients’ expectations have changed. They want care that’s convenient, continuous, and connected—whether that means a visit in the office, a video call from home, or a quick message sent from their phone.

But improving access can’t fall solely on the shoulders of primary care clinicians—especially when they’re already navigating broken payment systems and mounting administrative burden. The traditional model—one clinician, one office, one type of visit—isn’t just outdated for patients. It’s unsustainable for clinicians.

The Scorecard highlights how access remains uneven and often inequitable, particularly for marginalized communities. To fix that, we need flexible, team-based, and tech-enabled models that don’t just expand care options—but do so in a way that works for clinicians.

At Elation, we’re building tools that make this possible. Named Best in KLAS for Telehealth—for the second year in a row—we support practices with solutions that integrate seamlessly into their workflows, helping care teams deliver high-quality, relationship-centered care across every touchpoint.

See why clinicians trust Elation’s telehealth platform.

The future of access must balance patient convenience with clinician sustainability. That means redesigning not only care models, but also payment structures and support systems. Because better access only leads to better outcomes when it works for everyone—patients and the people who care for them.

The Way Forward

The Milbank 2025 Scorecard doesn’t just illuminate the challenges in healthcare—it offers a roadmap for what’s possible and what’s essential.  That roadmap starts with primary care. Because primary care isn’t just another budget line—it’s the foundation of a high-functioning, cost-effective health system. Investing in primary care is investing in the future of American healthcare—because the most effective way to lower costs and improve outcomes is to prevent problems before they start. No other part of the system does more to keep people healthy and reduce avoidable spending. 

We have the data. We have the tools. What we need now is alignment, sustained investment, and the courage to act. 

At Elation, we’re proud to stand beside the primary care leaders who are already building that future—through thoughtful technology, sustainable practice models, and an unshakable commitment to the physician-patient relationship. The future of healthcare depends on primary care. Let’s build it together.