The Triple Double: Doubling Down on Primary Care

The Issue:
The 2025 U.S. Primary Care Scorecard warns that chronic underinvestment in primary care threatens community health nationwide. Researchers at the Robert Graham Center, with support from the Milbank Memorial Fund and The Physicians Foundation, found the U.S. spends less than 5% of health dollars on primary care—and that share is shrinking. Only 20% of new physicians choose primary care, fueling workforce shortages and access gaps. Today, 30% of adults and 12% of children lack a regular source of care—even as insurance coverage expands.

Policy Can Help:
One bright spot: areas with higher social disadvantage have more primary care physicians, likely due to community health centers, which deliver affordable, comprehensive care to 1 in 10 Americans annually.

The Rallying Cry:
To reverse these trends, Asaf Bitton, MD, MPH, executive director of Ariadne Labs, calls for a Primary Care “Triple Double” by 2030:

Double primary care spending (5% → 10%)
Double patients served by community health centers (10% → 20%)
Double new physicians entering primary care (20% → 40%)

The State of the States:
Maps below show how close each state is to these targets and provide a baseline ranking of primary care performance.