Commission backs OIC study to design primary-care financing; one member objects

The Universal Healthcare Commission voted Sept. 3 to support the Office of the Insurance Commissioner’s (OIC) proposed design and study of a primary-care financing and payment model that would create a multi-payer common fund and prospective per-member-per-month payments for primary-care practices.

Commissioner Patty Kuderer and OIC staff presented a planning bill that would direct the OIC, in consultation with HCA and other agencies, to design and model a primary-care payment approach and deliver a proposed implementation plan and timelines to the legislature by June 30, 2028. The design work would be funded from the OIC regulatory account, the presentation said, avoiding a general-fund request for the planning stage.

Commissioners discussed how the model would interact with existing insurance: OIC staff explained the concept would carve primary care out of traditional insurance and pay attributed practices via a PMPM; prescription drugs, specialty and hospital care would remain under traditional payers. During Q&A, Rep. Joe Schmick raised workforce and rural-access concerns; OIC staff and commissioners said implementation planning would examine workforce pipeline issues and geographic pilots.

A motion to support the OIC’s design and study was moved and seconded; the motion carried on voice vote with Representative Joe Schmick recorded as opposed. The work group recommended that OIC use its commission seat to deliver regular updates.

Why it matters: The vote authorizes formal commission backing for OIC’s planning work and signals a pathway to a legislatively delivered design for primary-care financing that could be used to pilot or transition primary-care payments outside traditional insurance.

Provenance: Commissioners’ discussion and vote during the Sept. 3 Universal Healthcare Commission meeting; OIC materials included an appendix draft of proposed legislation and timeline for a 2028 report.

Quote: "The concept here is that it would... primary care only would be carved out of the traditional insurance model," OIC staff explained to the commission during Q&A.