Benefits of Adding Primary Care Services to Your Urgent Care 

In the last few years, the Centers for Medicare & Medicaid Services (CMS) has accelerated its long-term effort to strengthen primary care as the foundation of the U.S. health system. Through new payment models, regulatory changes, and equity-driven initiatives, CMS aims to rebalance healthcare spending toward prevention, care coordination, and whole-person health. All these are areas historically underfunded compared to specialty or hospital care. 

Major policy changes have been enacted through the Physician Fee Schedule (PFS). The 2024 final rule increased payment for longitudinal and continuous primary care, introducing or expanding billing codes for community health integration, caregiver training, and social determinants of health (SDOH) risk assessments. These updates formally recognize the growing scope of primary care, which now includes behavioral health integration, chronic disease management, and coordination with community services. 

Looking ahead, proposed 2026 payment adjustments signal an even more fundamental shift. CMS is considering reducing payments for hospital outpatient departments while increasing reimbursement for office-based and time-intensive specialties such as primary care and psychiatry. This rebalancing aims to correct long-standing financial distortions that favored hospital consolidation and procedure-based revenue over prevention and continuity of care. 

The push toward advanced primary care reflects changing realities in healthcare delivery. Between 2000 and 2019, the share of Medicare beneficiaries seeing five or more physicians annually rose from 18 percent to 30 percent. During that period, the average primary care clinician had to coordinate with nearly twice as many other providers, jumping from 52 to 95. 

This fragmentation drives inefficiency, duplication, and burnout. CMS argues that primary care teams, supported by adequate funding, data tools, and flexibility, can help patients navigate the system more effectively. By addressing issues early, managing chronic illness, and linking patients to behavioral or social support, robust primary care can reduce avoidable hospitalizations and emergency visits. 

CMS also notes that the U.S. spends less than 5–7 percent of total healthcare expenditures on primary care, compared with roughly double that share in many other high-income nations. Strengthening primary care, the agency believes, is essential not only for cost control but also for health equity and patient trust. 

Whole-Person Care and the Changing Definition of Primary Care

This “whole person” philosophy reflects a broader cultural change within Medicare and Medicaid policy. Rather than viewing social and behavioral factors as peripheral to medical care, CMS now treats them as integral components of health. The agency’s inclusion of SDOH assessments, caregiver support, and community resource navigation in payment structures is a concrete step toward operationalizing that belief. 

CMS’s commitment to primary care reform is long-term and iterative. While implementation challenges remain, the direction is clear: CMS intends to make primary care the central organizing principle of American healthcare. History shows us that private payers will follow CMS’s lead when creating their policies. 

By investing in prevention, relationships, and community-based care, CMS is betting that a stronger primary care system will deliver healthier patients, more resilient providers, and a more sustainable Medicare program for the future. 

The Opportunity for Urgent Care Centers

As CMS works to strengthen primary care nationally, urgent care operators are finding an opportunity to align with this trend by integrating, or running parallel, primary care services within their centers. 

Urgent care has traditionally served as a convenient, episodic option for “working age” adults and their families who need quick treatment for illness or injury. However, this same demographic often lacks a regular primary care provider (PCP). Without routine wellness visits, chronic disease management, or preventive screenings, many patients miss key components of long-term health. 

How Adding Primary Care Services Strengthens Urgent Care Operations

The national shortage of PCPs is deepening this gap. The Association of American Medical Colleges projects that up to 124,000 physicians could retire by 2024, nearly 48,000 of them in primary care, leaving underserved communities short by more than 180,000 providers. As demand outpaces supply, urgent care centers are strategically positioned to help fill the void by offering accessible, community-based care at extended hours and familiar locations. 

Adding primary care services can create a parallel revenue stream while strengthening patient loyalty. Services such as annual physicals, immunizations, chronic disease follow-up, and preventive screenings naturally complement urgent care’s existing offerings. This approach allows centers to transition from one-time visits to ongoing relationships, turning occasional patients into long-term ones. 

Overcoming Workflow and Operational Challenges

However, experts emphasize that urgent care and primary care operate differently. Urgent care focuses on high patient throughput, while primary care requires time-intensive visits and continuity. To avoid workflow conflicts, many operators are launching primary care as a separate but co-located entity. This model involves distinct payer contracts, billing systems, and provider teams while sharing the same facility. Patients experience a seamless environment, while the business gains operational clarity and sustainable growth. 

Building the Future — Integrated, Community-Based Care

By running primary care parallel to urgent care, centers can meet rising demand, expand community access, and capture new market, all without diluting their core mission. In an era when CMS is rewarding whole-person, value-based care, urgent care operators have a timely chance to evolve into true front doors for comprehensive health.