“Every good outcome I have seen in value-based care started with a primary care team that knew the patient, from the front-desk staff who talked someone into coming in when they felt fine, to the provider who caught what nobody else was looking for. Our job is to take work off their plate, and to make sure they are paid for the work that stays.”
— Dr. Sherri Onyiego, Market Medical Director, Texas, Equality Health
National Primary Care Week runs from October 5 through October 9 this year [1], and there will be many thank-you messages, all of them deserved. We wanted ours to come with something more, which is an honest look at what primary care teams are carrying right now, and an equally honest account of what we are doing to help.
What primary care is carrying
There is some good news to begin with. Burnout among family physicians has been easing, from 51% in 2023 to 45% in 2025, according to the American Medical Association’s national survey [2]. That is real progress, and it is also still among the highest rates of any specialty. In the Commonwealth Fund’s 2025 survey of primary care physicians in 10 countries, more than two in five in the United States reported burnout, and the reason they named most often was administrative burden [3].
The numbers behind that burden are striking. One study found that a primary care provider would need 26.7 hours a day to deliver all of the care that guidelines recommend [4]. Another found that primary care physicians spend about 36 minutes in the electronic health record for every 30-minute visit, some of it at home in the evening [5]. Practices complete about 40 prior authorizations per physician each week, which takes physicians and staff roughly 13 hours [6]. And value-based care, for all the good it can do, has added to the pile. The average primary care physician now answers to 57 quality measures across about 11 value-based contracts [7]. Organizations like ours have a responsibility to make that simpler rather than heavier.
Through all of it, the reason people stay has not changed. In a national survey of primary care clinicians, more than half agreed with a simple statement: “My relationships with my patients keeps me going.” In that same survey, only 24% said their practice was fully staffed [8].
Running an independent practice in 2026
Many of the practices we work with are independent, and that path has grown steeper. The share of physicians working in private practice fell from 60% in 2012 to 42% in 2024, and the physicians who sold their practices most often pointed to two things, which were the need to negotiate better payment rates and the weight of regulatory and administrative requirements [9]. Costs keep climbing as well. In a 2026 poll of medical groups, 84% reported higher operating costs than the year before [10].
For practices that care for Medicaid members, the arithmetic is harder still. Medicaid pays physicians about 71% of what Medicare pays for the same services [11], and primary care as a whole receives just 4.5% of the nation’s health spending [12]. Choosing to stay independent, and to keep the doors open in the neighborhoods that need them most, is an act of commitment that deserves to be named.
Primary care comes in many forms
It also deserves to be said that primary care is much bigger than any one kind of practice. Community health centers cared for more than 32 million people in 2025, and nine in 10 of them lived at or below twice the federal poverty level [13]. More than 461,000 nurse practitioners are licensed in the United States, and about 87% of them are prepared in primary care [14]. There are roughly 5,650 rural health clinics [15] and about 3,900 school-based health centers, most of them serving schools in lower-income communities [16]. Alongside all of them are community health workers, whose numbers are growing [17], and whose work of meeting people where they are is very hard to replace.
To every one of those teams, this week is yours, too.
Why thanks matters, and why it is not enough
Appreciation is more than a courtesy. In a study of more than 37,000 healthcare workers, those who felt highly valued by their organization had far lower odds of burnout, and far lower odds of planning to leave [18]. Among burned-out primary care physicians in the Commonwealth Fund survey, about one in five said that feeling undervalued was the main reason [3].
So we believe a thank-you is worth saying out loud. We also believe it only means something when it comes with action, and for us that action takes three forms.
The first is to pay for results without adding paperwork. Our activity-based payment program pays practices each quarter, and for Medicaid in 2026 we removed required activities and chart uploads, so that a claim is enough to confirm the work [19].
The second is to offer technology that fits what a practice uses today. CareEmpower® works alongside more than 36 electronic health record systems, which means a team does not have to change systems to see which patients need what [20].
The third is to carry some of the load ourselves. Every practice has a Provider Account Manager, a Practice Performance Advisor, and a Provider Support Team to call on. Our Care Specialists and community health workers help patients with scheduling, reminders, and rides, and this year we also supported practices’ applications to the Rural Health Transformation Program [21].
What you told us, and where it stands
In this year’s survey, providers gave us a Net Promoter Score of +53, and 82% told us they plan to stay with us [22]. We are grateful for that, and even more grateful for the candor that came with it, because providers also told us plainly what would make their days easier.
Some of that work is done. This summer we sat down with practices for a round of user research that is now shaping how CareEmpower will work in the year ahead. We opened the first phase of a CareEmpower Knowledge Center, with a place to send us feedback and notes on every release. And in September we updated the logic behind the CareEmpower worklist, so that it does a better job of pointing a team to the patients who need them most.
More of it is in flight. The worklist is growing from visits alone to visits and priority screenings. We are building a simple way for a practice to tell us when a patient is not theirs, and the look and feel of CareEmpower is being refreshed based on what practices showed us. Work is also underway to bring the right information to the point of care, to reduce the number of chart requests that land on office staff, and to rebuild the way we welcome new practices, so that the first 90 days feel more structured and more supported. We have also heard how frustrating it is when a health plan’s list of patients does not match the patients a practice actually sees, and finding a better approach to that is on our roadmap.
It takes all of us
None of this works without everyone doing their part. Health plans make the model possible, and they can help a great deal by keeping what they ask of a small practice simple. Patients complete the picture each time they come in.
To the primary care providers, nurse practitioners, physician assistants, nurses, medical assistants, community health workers, and front-desk teams across our five states, and to everyone practicing primary care wherever you are, thank you. We will keep working to lighten the load.
References
1. American Medical Student Association. National Primary Care Week, October 5–9, 2026. https://www.amsa.org/event/national-primary-care-week/
2. American Medical Association. Organizational Biopsy national comparison data, 2023–2025 (family medicine burnout 51% in 2023, 45% in 2025). https://www.ama-assn.org/practice-management/physician-health/these-9-physician-specialties-report-highest-burnout-rates
3. The Commonwealth Fund. 2025 International Health Policy Survey of Primary Care Physicians, published November 20, 2025. https://www.commonwealthfund.org/publications/surveys/2025/nov/causes-impacts-burnout-primary-care-physicians-10-countries
4. Porter J, et al. Journal of General Internal Medicine, 2022 (26.7 hours a day; 9.3 hours with team-based care). https://www.uchicagomedicine.org/forefront/research-and-discoveries-articles/primary-care-doctors-would-need-more-than-24-hours-per-day-to-provide-recommended-care
5. Rotenstein L, et al. JAMA Network Open, January 2024 (median 36.2 EHR minutes per visit). https://www.ama-assn.org/practice-management/digital-health/primary-care-visits-run-half-hour-time-ehr-36-minutes
6. American Medical Association. 2025 Prior Authorization Physician Survey. https://www.ama-assn.org/system/files/prior-authorization-survey.pdf
7. Boone C, et al. “Value-Based Contracting in Clinical Care.” JAMA Health Forum, August 23, 2024 (mean 57.08 quality measures across 11.18 contracts). https://jamanetwork.com/journals/jama-health-forum/fullarticle/2822685
8. Larry A. Green Center. “The Pulse of Primary Care.” Journal of General Internal Medicine, 2025;40(15):3775–3777 (2024 survey of 786 clinicians). https://link.springer.com/article/10.1007/s11606-025-09561-z
9. American Medical Association. Physician Practice Benchmark Survey, 2024. https://www.ama-assn.org/practice-management/private-practices/smaller-share-doctors-private-practice-ever
10. MGMA Stat poll, June 23, 2026. https://www.mgma.com/mgma-stat/operating-costs-keep-climbing-for-medical-practices-in-2026
11. Skopec L, Pugazhendhi A, Zuckerman S. Health Affairs, 2025;44(5):531–538. https://pubmed.ncbi.nlm.nih.gov/40324136/
12. Milbank Memorial Fund and The Physicians Foundation. 2026 Primary Care Scorecard (2023 data). https://www.milbank.org/2026/02/2026-primary-care-scorecard-shows-continued-underinvestment-workforce-strain/
13. Health Resources and Services Administration. Uniform Data System, 2025 national data (32.7 million patients; 89.97% at or below 200% of the federal poverty level). https://data.hrsa.gov/tools/data-reporting/program-data/national
14. American Association of Nurse Practitioners. “Nurse Practitioners in Primary Care,” 2025. https://www.aanp.org/advocacy/advocacy-resource/position-statements/nurse-practitioners-in-primary-care
15. Rural Health Information Hub. Rural Health Clinics, March 2026. https://www.ruralhealthinfo.org/topics/rural-health-clinics
16. School-Based Health Alliance. Findings from the 2022 National Census of School-Based Health Centers. https://sbh4all.org/wp-content/uploads/2023/10/FINDINGS-FROM-THE-2022-NATIONAL-CENSUS-OF-SCHOOL-BASED-HEALTH-CENTERS-09.20.23.pdf
17. U.S. Bureau of Labor Statistics. Occupational Outlook Handbook, Community Health Workers (13% projected growth, 2025–2035). https://www.bls.gov/ooh/community-and-social-service/community-health-workers.htm
18. Stillman M, Sinsky C, Linzer M, et al. BMJ Leader, 2024 (37,685 healthcare workers). https://pmc.ncbi.nlm.nih.gov/articles/PMC12038114/
19. Equality Health. “2026 ECIP Overview Presentation” (provider-facing), slides 2 and 5.
20. Equality Health. CareEmpower® platform overview (EHR integrations).
21. Equality Health. Provider support model and Rural Health Transformation Program application support, 2026.
22. Equality Health. 2026 provider experience survey results, published August 2026.
