Many of the capabilities needed to deliver accessible, high-quality primary care have been defined, but little is known about how their implementation has changed in US practices over the course of the COVID-19 pandemic or about the factors associated with greater capabilities. In this cohort study, over the time period including the COVID-19 pandemic, primary care practices reported a decline in access to care, while average practice capabilities improved. Integrated practice ownership and ACO participation were both associated with better access and capability scores, suggesting that value-based payment and integrated care delivery support the development of higher-quality primary care. Variations across practices point to large opportunities for improvement overall and underscore the importance of incentives and structures as levers to improve primary care delivery.

Mackwood, M., Fisher, E., Schmidt, R. O., Yang, C. W. W., O’Malley, A. J., Rodriguez, H. P., ... & Schifferdecker, K. E. (2025, February). Changes in US Primary Care Access and Capabilities During the COVID-19 Pandemic. In JAMA Health Forum (Vol. 6, No. 2, pp. e245237-e245237). American Medical Association.