Key Takeaways
- California has established a benchmark to raise primary care spending to 15% of total health care expenditures by 2034, requiring coordinated action across health plans, purchasers, and providers.
- Meeting the benchmark will require more than increased spending. Health plans can advance progress through three priority levers: contracting, network design and delegation, and practice capability and infrastructure support.
- Effective strategies must reflect California’s diverse primary care landscape and prioritize the patients and communities who stand to benefit most from stronger, more accessible primary care.
Robust primary care is associated with improved health outcomes, lower total costs of care, and reduced disparities. California, however, has historically directed a smaller share of its health care spending to primary care than peer states and systems. In October 2024, the Office of Health Care Affordability (OHCA) Board adopted a statewide benchmark to raise primary care spending to 15% of total health care expenditures by 2034. OHCA will measure progress across commercial plans, Medi-Cal managed care plans, and Medicare Advantage plans.
This brief is intended for the health plan leaders, purchasers, and provider organizations working to translate California’s benchmark into measurable change. It offers a practical framework to help stakeholders identify where they have the greatest influence, prioritize high-impact strategies, and take coordinated action to strengthen primary care for every Californian.
Convening California’s Primary Care Leaders
In November 2025, CHCF convened health plan leaders, purchasers, providers, and policy experts to examine how California can advance primary care investments. What emerged was a shared, actionable framework, a set of broad levers distilled into six priority strategies that plans and their partners can advance now.
Levers for Increasing Primary Care Investment
- Contracting. Increasing the share of medical spending that flows directly to primary care providers through payments, contracts, and supplemental funding.
- Networks. Strengthening the systems, workforce, and tools primary care practices need to deliver high-quality, high-value care.
- Practice Capabilities. Enhancing the team-based care and data infrastructure needed to deliver advanced primary care.
6 Strategies to Move from Benchmark to Action
- Enhance Primary Care Provider Payments
- Implement Payment Models That Support Team-Based Care
- Invest in Primary Care Infrastructure and Workforce
- Support Practice Transformation and Data Capabilities
- Align Measurement and Reporting Across Payers
- Build Accountability Through Transparent Tracking
Read the full issue brief for detailed guidance on each strategy.
A Shared Path Forward
Together, these strategies offer health plans a shared roadmap for meeting OHCA’s primary care investment benchmark, flexible across markets and provider types and grounded in practical action. And as federal and state budget pressures tighten, the case for investing in primary care will only grow stronger because it is the foundation of a more sustainable, equitable health system for every Californian.
