SynthesisJAMA health forum2025
Federal Investment in Primary Care Transformation: A Systematic Review and Qualitative Analysis.
Synthesis in JAMA health forum, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Understanding the results of federal investment in primary care delivery and transformation is essential for informing practitioners, future program developers, and policymakers on how best to improve delivery of primary care. Objective: To identify outcomes of federal investment in primary care delivery transformation on patient experience, costs and utilization, population health, and practice experience. Evidence Review: Publicly available program evaluation reports and articles published between July 2011 (the start of the earliest identified programs) and December 31, 2024, were identified on PubMed, Scopus, CINAHL, Embase, Web of Science, and the Cochrane Library. The review included independently evaluated federal programs started after January 2011 and completed by December 2021. Findings: A total of 142 records were included in the analysis from 5 programs that met inclusion criteria: the Federally Qualified Health Center Advanced Primary Care Practice demonstration, the Multi-Payer Advanced Primary Care Practice model, the Comprehensive Primary Care (CPC) initiative, CPC Plus, and EvidenceNOW Advancing Heart Health. Programs supported practice-level changes in care delivery through payment changes, performance requirements, data feedback, and technical assistance. Federal investments were associated with substantial improvements in clinical care delivery, greater patient engagement, modest reductions in utilization, and net increases in expenditures. There was an association between practice efforts and intrinsic practice characteristics, and practices were limited by funding amounts and modality, difficulties in using electronic health records and payer data to support care improvement, staff turnover, and extrinsic factors. Conclusions and Relevance: This systematic review found that investing in primary care was associated with improvements in practice experience and population health, while outcomes regarding patient experience, costs, and utilization were mixed. Access to practice-level data and payment system challenges limited these impacts, and most outcomes were not seen until after at least 2 years. Countervailing payment incentives may have affected outcomes. Future primary care transformation efforts should focus on addressing practice-level barriers, aligning payment, and targeting support for practice-level organizational improvement based on local needs.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.