01/13/2026
Access to primary care is becoming increasingly fragile. From the perspective of Community Care Partners (CCP) and our fellow Massachusetts Community Partners, this is not abstract—it is what we see downstream every day.
When primary care access collapses, people do not disappear. They surface in emergency departments, inpatient units, and behavioral health crises—not because those settings are appropriate for routine care, but because they are often the only access left.
Our care coordination teams support members who:
• cannot establish primary care for months
• have lost long-standing physicians to burnout or early retirement
• rely on emergency departments for medication refills and chronic disease management
We also know that many of the members we serve—when properly supported in primary care—require more time in appointments, experience difficulty with timeliness, and face significant health-related social needs that affect access, engagement, and continuity of care. These realities are not barriers of motivation; they are reflections of complexity.
As primary care capacity erodes, system-wide stress increases. Expectations often shift—implicitly—onto care coordination teams to resolve gaps that no longer have providers, appointments, or treatment pathways behind them.
Care coordination, community health workers, nurses, social workers, and interdisciplinary teams—across CCP and our fellow Community Partners—work every day to stabilize care, build trust, and support member engagement. But these roles cannot replace primary care, especially when part of the purpose of our program is to connect vulnerable persons to primary care. We can only mitigate the impact of primary care absence for so long.
From a population health lens, the communities hit first and hardest are those already facing the greatest barriers: rural populations; publicly insured and low-income individuals; people living with chronic illness, disability, or serious mental illness; and immigrant communities. In Massachusetts, these are the very members served by Community Partner programs.
Workforce expansion and training pipelines matter. But without addressing the underlying causes, the system risks accelerating churn rather than building stability.
Care coordination can stabilize gaps—but it cannot replace primary care.
