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Published: May 7, 2020

We need all family physicians to act now!

Legislators are making decisions RIGHT NOW on this year’s State Budget. With family physicians and patients facing multiple crises, we need YOU to contact your legislators IMMEDIATELY urge them to take action to help. Please read the information below so that you can call your legislators and ask them to take THREE specific actions:

  • Prevent cuts to the Song-Brown Primary Care Physician Training program.
  • Require health plans to support primary care practices by providing prospective
  • Help transform primary care payment and delivery for the future.

Click Here to Call Your Legislators Now!


1. The Ask: Save the Song-Brown Program and Access to Primary Care

The Song-Brown program provides funding for primary care residency training programs with a proven track record of graduating physicians who practice primary care in underserved areas serving underserved populations, including seniors, children, and those with special needs. The Governor’s budget proposes to cut it by $33 million – more than 90 percent of its funding. It is the last thing we should cut during a health care crisis.

In the last three years alone, Song-Brown helped to create and fund:

  • 23 new residency programs
  • 36 new slots at existing residency programs
  • 600+ new primary care physician residents

The program helps get needed services to communities immediately. Each family medicine resident provides an average of at least 600 additional primary care patient visits per year while in training. Supporting family medicine residency programs also has significant long-term benefits for communities, as the majority of residents stay and practice in the areas in which they train.


  • REJECT the Governor’s proposed cut to the Song-Brown program.
  • Without this funding, many programs will be forced to close, eliminating access to primary care for underserved populations, including seniors, children, and those with special needs.
  • This cut will do little to fix our budget shortfall, yet it will significantly undermine access to primary care for years to come.

2. The Ask: Save Primary Care Practices Before It’s Too Late

The COVID-19 pandemic has shaken our society to the core, sending millions of Californians reeling, and leaving no sector of the economy unaffected. Recent studies indicate nearly 80 percent of primary care clinicians are experiencing “severe” or “close to severe” financial strain as a result of COVID-19. Shortly after physical distancing measures went into effect around the state, CAFP surveyed our members and more than 90 percent of respondents were concerned about the financial sustainability of their practice. Patients are forgoing essential care for chronic disease management, preventive services, and mental health care. This results in a significant deterioration of patient health, but also risks the closure of primary care practices throughout the state. We must immediately save our primary care infrastructure from fiscal collapse to ensure it can meet the needs of the current state of emergency, as well as the pent-up post-pandemic demand sure to follow. And we can do that without any impact on the State’s General Fund.

California’s health plans and insurers remain quite profitable as they continue to collect patient premiums without paying out as much for services. In fact, Moody’s Investors Service predicts most health insurers will remain profitable over the next few years.


  • Primary care practices are collapsing under fiscal strain and profitable health plans and insurers must share in the solution to save them.
  • The State should require health plans and insurers to pay primary care physicians based on the amounts they received on March, April, May, and June of 2019. The payments should then continue month-to-month until the State of Emergency ends. This critical requirement must begin as soon as possible.
  • This solution would cost nothing to the State’s General Fund while ensuring access to care during this crisis and beyond.

3. The Ask: Transform Primary Care to Value-Based Payment and Delivery

If there is one positive to emerge from the current catastrophe, it is that a unique opportunity now exists to reorganize primary care and address long-festering problems at the heart of our health care system. Not only will this help ensure that primary care physician practices remain solvent, it can also play a pivotal role in optimizing the larger health care system. Even before the pandemic began, lack of support for primary care left us with an insufficient workforce and the continued decline of patients having a usual source of primary care. We must ensure that patients have access to the chronic care management and disease prevention that primary care provides. While prospective payment is a necessary lifeline to keep primary care practices open, we must take action to ensure California does not return to its broken and dysfunctional health care system when the initial stages of this crisis pass. This prospective payment should act as a jumping off point to build upon important payment reform.


  • A strong foundation of primary care is critically important during pandemics like COVID-19, as practices are a natural fit for triaging, testing, treating, and educating patients.
  • The state must also work to transform primary care payment to make our system better prepared for the future. This can’t wait for the next crisis.
  • The State should convene payers, providers and consumers to identify how our system can move primary care to value-based payment – aligning payment, reporting, and infrastructure investments – and finally providing the real resources needed for a robust primary care foundation to California’s health care system. This can be done through a new forward-thinking global payment model coupled with performance-based incentive payments that hold physicians accountable for quality and costs.

Please call your legislators IMMEDIATELY to deliver these messages using this link, and encourage all of your colleagues to do the same. Then let us know you have taken action by clicking here.

Connect with your local CAFP chapter

Find fellow family physicians in your neighborhood.
(415) 345-8667
1520 Pacific Avenue, San Francisco, CA 94109
© 2019 California Academy of Family Physicians. All Rights Reserved.
link to FPPAC homepage
link to FMRevolution.org
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