PBGH Review Finds Virtual Primary Care Is Advancing, but Quality Measurement Has Yet to Catch Up

Findings from 15 vendors will inform the Purchaser Business Group on Health’s Soon-to-Launch National Advanced Primary Care Network

OAKLAND, CA, UNITED STATES, November 12, 2026 /EINPresswire.com/ — Virtual primary care vendors are making progress on payment models and behavioral health, but their quality reporting lags behind in-person models, according to a new review from the Purchaser Business Group on Health (PBGH), a nonprofit coalition of large employers and public purchasers.

Released today, PBGH’s “Trends in Virtual Advanced Primary Care Through the Purchaser Lens” review examines how virtual primary care vendors measure up against purchaser expectations for Advanced Primary Care (APC). The review comes as PBGH builds a National APC Network to make it easier for purchasers to offer high-quality APC across markets.

“Primary care is one of the best investments in health we can make, yet it has been underfunded and undervalued for decades,” said Elizabeth Mitchell, president and CEO of PBGH. “Our members are stepping in to change that, and they have defined what good primary care should look like.”

APC is high-quality primary care that puts patients at the center, with ready access, an ongoing relationship with a care team, and whole-person care that integrates behavioral health and coordinates care across settings. APC improves quality while lowering the total cost of care for workers and their families.

PBGH’s APC standards were developed with purchasers and clinical experts and build on years of hands-on work by the California Quality Collaborative (CQC), a PBGH program that helps primary care practices improve care delivery. The PBGH Care Excellence Program recognizes top-tier primary care teams that meet purchaser-defined expectations using shared measures of quality, access, patient experience and outcomes.

“As a physician, I’ve seen what Advanced Primary Care can do when one care team knows you, takes responsibility for your health, and coordinates your healthcare journey,” said Dr. Raymond Tsai, vice president, clinical strategy and innovation at PBGH. “Virtual care can bring that to many more people, especially where good in-person options are hard to find. However, we cannot assume all virtual care meets the APC standards that we know improve population health, deliver a positive patient experience, and reduce total cost of care by reducing waste in the healthcare system.”

PBGH issued a Request for Information (RFI) to find out how well virtual and digitally enabled primary care vendors meet PBGH’s APC standards. Four PBGH members championed the RFI and helped shape the questions around what purchasers need from virtual primary care.

Fifteen vendors responded, ranging from national health plans and network aggregators to virtual-only primary care providers. Responses were evaluated against the same quality and patient experience expectations PBGH applies to all APC.

The report’s findings include:

Payment models are moving beyond fee-for-service. Most offer alternative payment models, though what the fee includes varies.

Behavioral health is increasingly part of the model. Many report having behavioral health staff, though integration with the primary care team varies.

Quality reporting is limited. Just over half of the vendors reviewed report on at least some of the PBGH APC Measure Set, but few report on the full set, even though it is built on standard HEDIS measures that health plans and in-person practices routinely report.

Continuity is widely promised but rarely measured. Few vendors measure whether patients consistently see the same clinician or purposely designed primary care team.

Coordination beyond the virtual setting lacks a defined path. None had a fully mapped patient journey for when patients need in-person care that extends beyond their own organization.

PBGH is sharing results with participating vendors and will use the findings to inform the development of its new National Advanced Primary Care Network.

“PBGH members’ APC initiatives have saved hundreds of millions of dollars and avoided tens of thousands of hospital admissions,” said Mitchell. “When purchasers are clear about what they expect, the market responds. And because our standards are built on years of helping practices improve care, we know they’re achievable. We look forward to working with the market to meet the bar purchasers have set.”

About PBGH

The Purchaser Business Group Health (PBGH) is a nonprofit coalition of more than 40 large, self-insured employers dedicated to improving the quality and affordability of healthcare for American workers and their families. With 35 years of experience in employer health benefits strategy, PBGH works with employers, policymakers, and healthcare stakeholders to advance data-driven, high-value healthcare purchasing. For more information, visit pbgh.org.

James Chisum
Miller Geer & Associates
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