Continuity of Care: Health Benefits and Compensation

Kenny Lin, MD, MPH
February 16, 2026

Continuity of care—a trusting relationship with a personal physician based on recurring interactions over time—is an essential ingredient of the secret sauce of family medicine. Numerous studies have demonstrated that higher care continuity is associated with more appropriate care and lower costs. Data also support positive effects on health outcomes. A retrospective analysis from Alberta, Canada, reported that physician and clinic continuity (seeing a clinical partner when one’s primary physician was unavailable) correlated with fewer emergency department visits across all levels of patient complexity and fewer hospitalizations for highly complex patients. A similar US cohort study of Medicare fee-for-service claims from a nationally representative sample of 4,940 medical practices found that patients with higher primary care physician continuity were 5.5% to 6.8% less likely to be hospitalized and 4.9% to 6.3% less likely to visit the emergency department.

In 2023, the Accreditation Council for Graduate Medical Education changed the emphasis of family medicine resident training requirements from volume of encounters to continuity of care. In a special article published in Family Medicine, Dr. Gregory Garrison and colleagues described five domains of care continuity. In addition to traditional clinician-patient or “relational” continuity, they discussed benefits of informational (medical record), managerial (interdisciplinary care), family (caring for multiple family members), and geographical (care in multiple locations or environments, such as home, office, and hospital) continuity.

Unfortunately, the percentage of the US population who experience continuity of care has been decreasing since the turn of the century. A 2015 Graham Center Policy One-Pager found that fewer adults reported a personal physician (as opposed to a practice or facility) as their usual source of health care. From 2000 to 2019, the percentage of US patients who reported having a usual source of care declined from 84% to 74%.

To support continuity and compensate primary care clinicians for the additional complexity and cognitive load involved in these longitudinal relationships, the Centers for Medicare and Medicaid Services (CMS) introduced the add-on G2211 code in January 2024 and refined its use in 2025. Some private health insurers also recognize and pay for this code. A 2024 Graham Center analysis projected that applying the G2211 code to all eligible Medicare evaluation and management (E/M) visits would increase annual reimbursement by an average of $2,667 per physician. Attaching the G2211 code to E/M visits with 25 modifiers (approved by CMS in 2025) resulted in another $990 per physician. This year, G2211 codes also can be applied to home-based primary care visits. Relative to the established benefits of care continuity, the added compensation seems modest at best.