Clinics Sour on CMS After Agency Scraps 10-Year Primary Care Program Only Months In

Why It Matters

Eliminating Making Care Primary removes critical financial support for underserved primary‑care clinics, deepening access gaps and eroding provider confidence in federal health‑care reforms.

Key Takeaways

• CMS ended Making Care Primary after one year.
• Program cut intended to save $750 million taxpayers.
• Rural clinics lose expected $10 million funding stream.
• New LEAD model channels money to health organizations, not doctors.
• Provider trust in federal innovation programs declines sharply.

Pulse Analysis

The United States faces a mounting primary‑care shortage, with over 100 million Americans lacking a nearby provider. In response, CMS launched Making Care Primary to deliver direct payments to physicians for care coordination, transportation, and social‑determinant supports, especially in rural communities. The model promised to reduce hospitalizations and improve health outcomes while testing a new payment architecture that could reshape primary‑care financing.

When CMS abruptly cancelled the program in March, the impact was immediate. Clinics like Celo Health Center, which had counted on $10 million over a decade to hire staff, expand specialist networks, and provide patient transport, now confront a funding vacuum. Providers report heightened administrative burdens and a loss of trust in federal initiatives, fearing that future programs may be withdrawn without warning. The termination also signals a broader shift toward consolidating funds at the organizational level, potentially marginalizing small, independent practices that serve the most vulnerable populations.

CMS’s successor, the Long‑term Enhanced ACO Design (LEAD), redirects payments to larger health‑system entities rather than individual primary‑care sites. While this may streamline oversight, critics argue it adds bureaucratic layers and could dilute the direct incentives that made Making Care Primary attractive. The transition underscores the tension between cost containment and the need for sustained investment in primary care. Stakeholders will watch closely to see whether LEAD can deliver measurable savings without compromising access, or if the loss of direct clinic funding will exacerbate the rural health crisis.