Innovative payment and practice models in family medicine

Family medicine continues to evolve as new payment and care models emerge. These models are designed to improve outcomes, ease administrative burdens and make practice more sustainable. Use the tools, examples and CME resources on this page to explore different approaches and find what works best for your practice.

How you’re paid influences how you organize care—everything from the length of appointments to how you staff your practice. When payment levels are sufficient and the approach is not burdensome to practices, you and your care team can improve coordination, share tasks and focus on what matters most.

When these models are well designed for primary care, they can:

You don’t work alone. In team-based care, medical assistants, nurses, care coordinators and others work with you to support all of the services you provide to your patients, from preventive care to chronic disease management and follow-ups. Team-based care empowers your team to take on additional responsibilities and allows you to focus on all your patients, especially those with complex or high needs.

Traditional FFS payment continues to be the mainstay of health care payment, but it isn’t designed to support the continuous, relationship-based care you provide. FFS is built on task-based codes that are often undervalued and fall short in capturing the breadth of primary care. Value-based care looks beyond a volume-based FFS approach and aligns payment with the comprehensive care that improves health outcomes and makes health care more affordable.​​​​ Most practices are paid with a combination of FFS and VBP, and there is not one size fits all approach. You can optimize FFS to support the transition to VBP, engage in models with downside risk, join an ACO or other VBP partnership or explore other innovative pathways.

Practice ownership provides family physicians with autonomy and flexibility to serve their communities. Physicians in independent practices have a high level of connection with patients and are highly involved in business and management decisions required to sustain operations.

Direct primary care (DPC) is an alternative primary care delivery model that doesn’t rely on traditional insurance billing. Instead, patients pay a predictable monthly or annual fee directly to the practice, which typically covers most primary care services. By removing insurance-related administrative requirements, this model may allow physicians to spend more time with patients, streamline practice operations, and support stronger, continuous physician–patient relationships.

As a practicing family physician, you have important payment decisions to make about your Medicare participation. Learn how to optimize payment, understand your options and succeed in specific programs such as the Merit-based Incentive Payment System (MIPS) and alternative payment models (APMs).

At the federal and state levels, the AAFP continues to advocate for payment reforms that better reflect the realities of primary care. Our efforts focus on ensuring fair compensation for family physicians, reducing administrative burden and increasing investment in comprehensive, team-based care.