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A State Playbook for change: How to deliver primary care to all Americans

In a nation as developed as the United States, access to basic health care should be guaranteed for all citizens, no matter where they live, what their health condition is, or their economic status. Yet, the U.S. healthcare system often prioritizes profit over people, resulting in fragmented, costly, and often inaccessible care. 

The Primary Care for All Americans (PC4AA) movement is working to change that by advocating for high-quality primary care for everyone in America. PC4AA’s vision is simple but transformative: ensure that every American has a personal primary care clinician, and every neighborhood and community has a great primary care team. By including everyone in America, PC4AA’s efforts are designed to help improve public health, lower costs, and strengthen our democracy. And, each of us has the power to make change.

With individual empowerment in mind, PC4AA has introduced its first of two playbooks for change, one that delivers the tools and resources that makes it easier for advocates representing their home state to organize by sharing the objectives, key strategies, and tactics to consider for PC4AA state-level workgroups. The second playbook, to be released later this year, will provide organizing guidance for local communities.

Download the PC4AA State Playbook for Change

The state playbook delivers insights into primary care workforce, investments, and opportunities for change. It gives advocates the tools to mobilize grassroots efforts, build coalitions, and effectively engage with state policymakers and influencers. 

In short, it makes important work easy to start and maintain through actionable steps and access to resources—-helping ensure that all of us, across America, are building groundswells of change for broad transformation. 

Here are a few things to know about the playbook and how you can use it, starting today.

Why a state-level playbook for change?

State policymakers have tremendous influence on key issues relating to primary care access – including investments in the primary care workforce and infrastructure, Medicaid innovations, and value-aligned payment models. In addition to advocating for and influencing federal policy, state-focused work helps build momentum for the cause, raising awareness and creating more opportunity for change to move everyone closer to our goals.

Why form a workgroup? 

State workgroups help power and amplify and unify the voices of the many. Workgroups can look different and may include many different organizations and individuals, but each share a united vision for improved primary care for everyone in America. Despite different priorities each group may have, everyone in the workgroup should at a minimum agree on the vision and goals of Primary Care for All Americans.

What does the process look like?

Here is a preview of the six critical steps for state workgroups to follow in their advocacy efforts:

  1. Define the current state of primary care: Gather data on the local primary care landscape, identify gaps, and develop a comprehensive picture of the current challenges.

  2. Build a coalition: Collaborate with other organizations that share the vision of better primary care for all.

  3. Identify policy options: Look for opportunities to advance primary care through policy changes, including Medicaid reforms and workforce investments.

  4. Establish consensus: Work with coalition partners to prioritize goals and create a strategy for action.

  5. Identify policy champions: Engage local leaders and influencers to support and advocate for primary care reform.

  6. Provide an accountability structure: Monitor progress, set realistic milestones, and hold policymakers accountable for making sustainable changes.

Improving access to primary care is about more than just healthcare—it’s about equity, fairness, and the well-being of communities across the country. The PC4AA movement is working to realign the U.S. healthcare system to better serve all Americans, with primary care as the cornerstone. Through advocacy, coalition-building, and strategic action, the movement aims to make high-quality primary care available to everyone, creating a healthier, more equitable future for all.

Download the PC4AA Playbook for Change

About the Author

Elation’s Head of Primary Care Advancement and leader in primary care advocacy, Dr. Pastoor is board-certified and a clinically-active family medicine physician. As an experienced primary care innovator in military medicine, academic medicine, private practice, and employer-sponsored delivery models, Dr. Pastoor is an accomplished primary care champion and leader in patient-centered workflow, EHR optimization, and health system transformation.

Profile Photo of Dr. Sara Pastoor, MD, MHA