The purpose of this paper is to help states develop or refine a multi-payer primary care investment strategy. It presents a range of options for advancing and measuring investments in state-based primary care systems, with an emphasis on enhancing the engagement of commercial payers and aligning public and private payment and care delivery models. This paper begins by exploring the levers states can use to advance multi-payer primary care programs and policies. It then highlights the policy approaches some states have used to stimulate multi-payer investment in primary care, via revenue enhancement strategies and practice supports. The paper concludes with a review of metrics that could be used to monitor the impacts of primary care investment policies and track primary care system performance.

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