Turning Point for Primary Care: How North Carolina Leaders Are Charting a Path Forward 

North Carolina has long been a testing ground for primary care reform. Its early work through Community Care of North Carolina and the current Advanced Medical Home model under Medicaid Transformation have positioned the state as a national leader in population health and care management. 

But even with that strong foundation, primary care is under pressure — not just in North Carolina, but nationwide. 

The Health Resources and Services Administration projects a shortfall of more than 87,000 full-time equivalent primary care physicians by 2037.¹ Beyond that, more than 100 million Americans lack adequate access to primary care.² 

These realities framed the discussion at the North Carolina Primary Care Innovation Symposium, held July 29 in Raleigh. Hosted by the North Carolina Association of Health Plans (NCAHP), the event brought together public- and private-sector leaders from across health care, policy and technology to discuss strategies for strengthening primary care delivery and improving access to services. 

More than 50 leaders participated, representing payers, health systems, clinical organizations, technology companies, advocacy groups, and state policymakers. The breadth of attendees reflected a shared commitment to addressing the crisis through coordinated, cross-functional action. 

“Primary care is the foundation of our health system,” said state Sen. Jim Burgin, chair of the Senate Health Committee. “With the right investment, innovation and collaboration, North Carolina has an incredible opportunity to lead the nation in building a stronger, more accessible model of care.” 

Attendees discussed challenges familiar to many health care organizations: rising practice costs, clinician burnout, workforce shortages and the administrative burdens tied to modern documentation and reporting requirements. Independent and rural practices were noted as particularly vulnerable, often lacking the scale or infrastructure to absorb these pressures. 

Greg Griggs, CEO of the North Carolina Academy of Family Physicians, said the cost of running a private practice has increased up to 30 percent over the last five years. Payment rates, however, have not kept pace. He also pointed to the growing number of payers and value-based arrangements that require distinct performance reporting and quality tracking. 

“Our members want to spend time improving patient health,” Griggs said. “What makes work meaningful is time with patients. The more time spent on documentation or navigating fragmented requirements, the harder that becomes.” 

Value-based care remains a promising framework for improving health outcomes and controlling costs. Still, many practices — particularly smaller ones — find implementation complex. Differing metrics across payers and the operational capacity required to succeed in performance-based contracts are areas of ongoing concern. 

Panelists emphasized the need to simplify participation and align incentives in a way that rewards improved outcomes without creating unnecessary administrative complexity. 

Technology, they said, can help. But only when it is purpose-built and integrated thoughtfully into clinical workflows. 

During the symposium, Aashima Gupta, global director of Health Care Strategy and Solutions at Google Cloud, outlined the evolution of artificial intelligence in health care. She described how early AI tools are already helping reduce documentation burdens and how more advanced systems could help expand access and improve coordination without removing the physician from the care experience. 

“Imagine a future where every patient, regardless of ZIP Code, has access to timely, high-quality primary care,” Gupta said. “Where intelligent systems support care teams by reducing administrative burdens and optimizing workflows. That future is closer than many think.” 

One such example was Tom, Lumeris’ AI-powered virtual care team member. Demonstrated during the event, Tom is embedded in clinical workflows to autonomously recommend next best actions, reduce repetitive tasks and extend the reach of care teams. 

Mike Long, chairman and CEO of Lumeris, spoke to the scale of the challenge and the opportunity ahead. 

“Today, more than 100 million Americans either lack access to primary care or receive less than they need,” Long said. “The gap between supply and demand can’t be closed with workforce expansion alone. We need tools like Tom that are designed specifically for physicians, patients and the teams that support them.” 

The discussion returned often to the theme of coordinated action. Participants stressed that North Carolina’s strengths — including its policy leadership, innovative Medicaid model and cross-sector collaboration — offer a strong foundation for progress. But they also noted that success will depend on sustained investment, technology deployment, and meaningful support for clinicians on the front lines. 

Peter Daniel, executive director of NCAHP, closed the event by encouraging participants to move from conversation to execution. 

“The people in this room represent every part of the health care ecosystem,” Daniel said. “We now have an opportunity, and a responsibility, to take what we’ve discussed and translate it into meaningful steps forward.” 

Next steps include identifying pilot opportunities, aligning policy recommendations and coordinating public-private investments to help scale new models of care. 

As the conversation continues, one idea was clear: while the challenges facing primary care are national in scope, the solutions will be built community by community. North Carolina’s work offers a blueprint — and a call to action — for health care leaders across the country. 

Learn more about Tom and how Lumeris is helping close the primary care gap.