Independent primary care practices play an essential role in delivering health care in California. Several related developments in the health care market are converging to highlight the importance of supporting small independent primary care practices: market consolidation, acceleration of value-based payment, and a shortage of primary care providers. Yet the experiences independent primary care practices are often not well understood by policymakers and purchasers.

This brief – based on interviews with independent practices in Humbolt, Riverside, and San Bernardino Counties – can support purchasers and policymakers in understanding opportunities to strengthen and sustain independent primary care practices, including:

1. Streamlining clinical practices in the independent setting through reducing administrative burden by aligning processes and requirements across payers.
2. Supporting business operations of independent practices.
3. Improving financial feasibility for physicians to start or join independent practices and increase awareness of this option for physicians.
4. Committing to long-term investment in primary care, including increasing primary care reimbursement, and explicitly include independent practices.
5. Including independent primary care practices, including rural practices, in policy and purchasing decisions.

By strengthening the independent primary care sector, California can expand and diversify its health care workforce, preserve access to care, and even — given the connection between provider consolidation and higher price — mitigate health care cost growth.

Effectively supporting independent practices in California will take resources and investment from purchasers, payers, and policymakers. Many efforts are already underway; but more are needed.