MA H1370

Establishes statewide primary care expenditure targets: 10% of total health care expenditures in 2027, 12.5% in 2028, 15% in 2029, with a permanent floor of 15% and ceiling of 20% for 2030 and beyond

Creates a 25-member Primary Care Council within the Health Policy Commission to develop and recommend a voluntary prospective payment model allowing primary care providers to receive monthly lump sum payments instead of fee-for-service reimbursement

Eliminates patient cost-sharing (copays, coinsurance, deductibles) for primary care services delivered by providers participating in the prospective payment model

Requires at least 95% of payments under the model to go directly to primary care providers, with payment adjustments based on adoption of "primary care transformers" (e.g., community health workers, behavioral health integration, telehealth, same-day appointments)

Establishes a Primary Care Stabilization Fund funded by annual assessments on carriers, providers, and non-traditional healthcare entities (including retailers, pharmacy benefit managers, private equity firms, urgent care clinics) to finance the prospective payment system