Policy Priorities

PCDC supports policy initiatives that promote health equity by expanding and ensuring access to quality primary care for communities with the greatest need.

Advocating for Quality Primary Care

We support policies at the federal, state, and local level that promote health equity by expanding and ensuring access to quality primary care for disinvested communities and communities with the greatest need.

Quality primary care means primary care that is accessible, affordable, community-based, whole-person and integrated with behavioral health care.


  • Policy Agenda

    In 2023, we are working to advance policies that:
    • Create a primary-care centric health system that supports whole person, integrated, high-quality primary care for all people, including by:
    • Increasing investment in and improving payment models and reimbursement for all primary care services;
    • Increasing the proportion of the health care dollar spent on primary care and supporting the role of primary care in addressing public health crisis, including COVID and future pandemics; and
    • Centering primary care in regulatory and statutory improvements to the health care system.
    • Directly support capital investment in and sustainability for primary care providers in disinvested communities, so that they can provide the care needed in safe, welcoming, supportive, appropriately resourced facilities.  Key policies include:
      • Protecting, expanding, and stabilizing the federal New Markets Tax Credit Program, and
      • Stabilizing the 340B Program and ensure long-term stability and sustainability for Safety Net providers.
    PCDC strongly supports policies that:
    • Expand access to health insurance.
    • Enable more intentional and comprehensive integration of sexual and reproductive health care into primary care, including care related to maternal health, contraception, and abortion.
    • Move towards ending the HIV epidemic.
    • Support a sustainable, culturally competent workforce that cares for disinvested, low-income and rural communities.
    • On the local level, make access to primary care the focus on new health initiatives.
    • Treat gun safety as a public health issue, including measures that help primary care providers integrate counseling about gun safety and dealing with trauma into their regular practice.

  • Primary Care Centric Health System

    What is a Primary Care Centric Health System?

    Primary care is a cornerstone of vibrant, thriving communities and helps keep families healthy, children ready to learn, and adults able to pursue education and participate in the workforce. Primary care is also the only part of the health system that has been proven to lengthen lives and reduce inequities at the population level while reducing overall health care costs. Regular access to primary care is consistently associated with positive health outcomes, including reduced severe chronic conditions, fewer hospitalizations, fewer emergency department visits, and fewer surgeries.

    Despite primary care’s proven role in improving population health, increasing health equity, and reducing costs, primary care is underfunded and undervalued across the country. The complex nature of the United States health system often obscures the value of primary care, making it harder for policymakers and stakeholders to find policy options to create a strong, primary care-centric health system that could address many of our nation’s most difficult health care crises.

    However, experts in the field of primary care have helped describe a different vision of health care, one that centers primary care, leading to better outcomes and more health equity. PCDC advocates for policies that would move the health system towards this vision.

    “In a primary care–centered health system, all individuals would receive comprehensive, longitudinal, and coordinated care anchored in primary care.” The components of this primary care-centric system would include:

    • Clinicians with a holistic perspective and long-term relationship with their patients, providing:
    • Integrated care, including sexual and reproductive health care and behavioral health care;
    • Coordinated care, working with specialty care, home care, acute care, and post-acute care;
    • In a medical home where patients could seek care from their trusted clinicians and be sure that their perspective will be heard and valued and care, including referrals to specialists, discussed and agreed upon together; and,
    • Ongoing communication supported by a comprehensive primary care team.


    PCDC supports policies that would create a primary-care centric health system that supports whole person, integrated, high-quality primary care for all people, including:

    • Increasing investment in primary care
    • Centering primary care in regulatory and statutory improvements to the health care system
    • Capital investment in primary care
    • Additional policies supporting whole-person care

  • Primary Care Investment

    Investing in Primary Care

    Primary care is at the center of vibrant, thriving communities, helping keep families healthy and connected to important resources, children ready to learn, and adults able to pursue education and participate in the workforce.

    Primary care is the best way to deliver whole-person care that includes prevention, early diagnosis and treatment, integrated behavioral health screening and treatment, and coordination with other levels of care. But primary care has been underfunded for years. The lack of investment in primary care is one of the core problems affecting access to quality primary care in the United States. In the United States, primary care accounts for approximately 35% of all health care visits each year – yet only about five to seven percent of all health care expenditures are for primary care services. The lack of adequate funding for primary care impacts both patients and providers, and leads to inadequate access, low-quality care, poor health outcomes, and an overburdened and burnt-out workforce that loses experienced professionals and has trouble attracting new ones. The harms of underinvestment in primary care are not felt equally across populations but instead hit hardest in communities already suffering from other health and social inequities.

    Deliberately investing in primary care is one of the most effective ways to save lives, improve individual and community health, and move toward health equity.

    The Impact of Increasing Investment in Primary Care

    Increased Access to Primary Care Would Improve Health Equity and Health Outcomes
    Investment in Primary Care Would Help Address the Shortage of Primary Care Providers
    • There is a growing shortage of primary care providers in many communities across the country, including in New York. Increased payment to primary care providers for their services can incentivize more clinicians to specialize in primary care and reduce the chance of burnout that results in exits from the workforce.
    • An increase in primary care spending could allow providers to bring in more staff and technology to help with administrative tasks so they can spend more facetime with patients and focus on providing the care they were trained for, decreasing burnout and improving patient care.
    Increased Access to Primary Care Would Lower Overall Health Care Costs
    • Primary care helps prevent, identify, and treat diseases before they become more serious and more difficult to treat, which is more costly to both the patient and the health care system. Increasing access to timely, culturally competent, preventive services through primary care is critical to helping New Yorkers attain their highest possible level of health and protecting them from the high costs of advanced disease and emergency care.

  • Capital Investment in Primary Care

    Capital Investment in Primary Care

    Lack of access to capital has proven to be a root cause of systemic poverty and lack of social mobility found in low-income areas and communities of color.

    Community Development Financial Institutions (CDFIs) are government certified and regulated private organizations that partner with underserved communities to provide responsible, affordable lending and investments. CDFIs have proven to meet the socioeconomic needs of those who do not have access to traditional financing. PCDC’s mission as a CDFI is to create healthier and more equitable communities by building, expanding, and strengthening the national primary care infrastructure. PCDC has provided direct financing and leveraged more than $1.8 billion (hyperlink to new “our impact” page) across 249 primary care health center projects, yielding more than $5 of private investment for each $1 of public investment.

    Through our unique position as a non-profit CDFI focused exclusively on health care, PCDC supports capital investment in and sustainability for primary care providers in disinvested communities, so that they can provide the care needed in safe, welcoming, supportive, appropriately resourced facilities. Specifically, PCDC supports and advocates for policies that:

    • Protect, expand and stabilize the federal New Market Tax Credit Program, including by making the NMTC permanent and improving the program.
    • Stabilize the 340B Program and ensure long term stability and sustainability for Safety Net providers.
    • Provide additional and more flexible funding for the Revolving Loan Fund in New York State.

  • Additional Policy Priorities

    Expand access to health insurance

    High quality, integrated, patient-centered primary care saves lives, leads to better individual and community health, and is central to health equity. Low income communities, communities of color and other disinvested communities have the least access to primary care and the worst outcomes. Americans saw the tragic effects that lack of care had during the height of the COVID-19 pandemic, when communities that had the least access to primary care before the pandemic ended up with the worst outcomes.

    Many New Yorkers who are under-insured, uninsured or simply cannot access a primary care provider for a variety of reasons often put off seeking care until they must seek emergency care at a hospital. Many times, these emergency or hospital visits are the results of chronic diseases like heart disease or diabetes that would have been preventable and treatable if the patient had the ability to regular access a primary care physician.

    Expanding access to coverage for previously uninsured or underinsured groups can improve health and access to primary care, particularly with the right public education and support. PCDC is dedicated to expanding affordable healthcare access, while improving the quality of primary care for patients across the country. Our organization advocates for policies that will help achieve those goals, including supporting expanding access to health insurance coverage for as many United States residents as possible.

    Enable more intentional and comprehensive integration of sexual and reproductive health care into primary care, including and related to maternal health, contraception, and abortion.

    High-quality, integrated, patient-centered primary care saves lives, leads to better individual and community health, and is central to health equity. Sexual and reproductive health care are major components of primary care. Over the course of their patients’ reproductive lives, primary care providers directly provide and refer their patients to the reproductive health care they need, including birth control, preconception care, counseling, and abortion services.

    Women* see their primary care providers substantially more than men, especially during their reproductive years, and reproductive health care services, including those provided in primary care settings, are essential for the 72 million women of reproductive age in the US. In addition, nearly 25% of women will seek abortion care by the age of 45.

    *In addition to women, other individuals who do not identify as women, including transgender men and some non-binary people, may also have the capacity to become pregnant and need access to comprehensive reproductive health care, including contraception.

    Following the Dobbs decision in 2022, a number of states have enacted bans or stringent limitations on abortion, which has had a devastating impact not just abortion access but also access to contraception, counseling, and miscarriage and other maternal health care. The impact of these changes are felt most by those who already struggle to access health care, including those in low-income, underserved, and disinvested communities, as well as communities of color.  Moreover, as more women are forced to continue pregnancies they would otherwise have ended, it is important to note that Black women face additional risk as they “are three times more likely to die from a pregnancy-related cause than white women.”

    PCDC’s core mission includes expanding access to quality, patient-centered primary care, for all individuals in every part of our country. As PCDC works to build a patient-centered approach to health care with equitable and accessible primary care at its core, we call on all health care payers, providers, and policymakers to recognize sexual and reproductive health care, including abortion services, as an inseparable part of primary care, and that high-quality, comprehensive primary care should never be restricted or compromised based on politics or ideology.

    Move towards ending the HIV epidemic

    HIV care is primary care. PCDC advocates for protecting and expanding HIV prevention and treatment services as part of the national movement to increase access to and improve the quality of primary care.

    Despite major strides since the outbreak of the epidemic, including the advent of PrEP and PEP, disparities in access to care, treatment, and prevention remain urgent challenges. Notably, people of color, especially men who have sex with men, continue to see HIV transmission rates that are disproportionally high.

    Since 1993, PCDC has been working tirelessly to close gaps in primary care access for underserved and vulnerable communities, including people living with HIV. Through the joint efforts of organizations across the globe, the end of the HIV epidemic is in sight.

    As part of the national imperative to end the HIV epidemic, which aims to reduce new transmissions by 90 percent by 2030, PCDC is working closely with states, local communities, and national partners to support people living with or at risk for HIV. PCDC also collaborates with government partners to scale high-impact prevention, care, and treatment strategies — particularly for the hardest-hit communities.

    Because of the patient populations often accessing 340B pharmacy benefits, learn more about PCDC’s 340B policy priorities as well here.

    Support a sustainable, culturally competent workforce that care for disinvested, low-income and rural communities.

    If primary care is to fulfill its role as the foundation of an equitable health system, primary care providers and their teams must be supported, the pipeline into primary care must be robust, and experienced primary care health care professionals must be encouraged to stay in the field and train those coming into it.

    Unfortunately, rather than growing to meet the expanding need for care, the primary care workforce is currently unable to even meet current demand for care, largely due to physician shortages in the field. This shortage is expected to grow worse in future years – the American Association of Medical Colleges has estimated that by 2033, there will be a primary care workforce shortage ranging from 21,400 to 55,200 providers. This shortage of PCPs will have a devastating impact on rural and underserved communities.

    Moreover, patients are more likely to seek and utilize health services when their providers are able to provide culturally competent care. According to the Agency for Healthcare Research and Quality, “culturally competent care is defined as care that respects diversity in the patient population and cultural factors that can affect health and health care, such as language, communication styles, beliefs, attitudes, and behaviors.” To advance health equity and improve patient outcomes, it is critical to have providers that patients will trust and return to over time. Self-reported improvements in health behaviors, symptoms, quality of life, and satisfaction with treatment have been documented in association with higher trust in health care professionals.

    The lack of a sufficient, culturally-competent, diverse primary care workforce has many causes, including lower salary ranges for primary care physicians than specialists, high medical school debt, burnout, and the mismatch between where primary care providers are currently located and where the need is greatest.

    PCDC supports policies that will increase and diversify the primary care pipeline, support practitioners who choose to go into primary care and encourage others to consider it, and prioritize retaining experienced primary care providers in the field.

    On the local level, make access to primary care the focus of new health initiatives

    Primary care saves lives, improves individual and community health, and is central to health equity. In fact, primary care is the only part of the health system that has been proven to lengthen lives, reduce health disparities, and reduce costs. However, primary care remains overburdened and underinvested; the role of primary care in public health planning and emergency preparedness has been undervalued; and this failure to prioritize primary care has been felt most acutely by marginalized communities.

    As the COVID-19 pandemic starkly illustrated, cities often do not prioritize primary care. Local health planners must think critically about the role of primary care in its resiliency efforts, planning for future public health crises, and accelerating efforts to address the disparities that have been so starkly illuminated. Primary care not only keeps people healthy and protected against severe disease and reduces health disparities, but “the primary care sector has an essential role in public health emergency preparedness” as well.

    In addition, cities can help address the overall workforce challenges facing primary care.  Investing more resources into primary care is a critical way to achieve the kind of robust health care system our communities deserve, including by expanding the number and diversity of providers who enter primary care and who accept new patients, including those with Medicaid coverage.  This kind of investment can be through reimbursement and incentive payments, but can also be in the form of capital.

    In particular, cities can encourage the new construction of Federally Qualified Health Centers (FQHCs).  FQHCs are an incredible source of care for low-income people and have a clear impact on improving individual and community health.  For example, in 2021, PCDC conducted research on the role of FQHCs on COVID outcomes and concluded that “Federally-Qualified Health Centers help[ed] reduce community-level COVID-19 mortality.” One important step that cities can take towards expanding access to care would be to conduct or support a study of existing FQHC locations, to identify whether there are areas in their city that would benefit from additional FQHC facilities. Given FQHCs direct role in helping keep communities healthy, identifying neighborhoods that lack this critical source of care could help support efforts to draw capital investment to increase access.