Primary care preceptorships

AN ACT Relating to the use of preceptorships to train primary 1
care physicians; amending RCW 70.390.080; and creating a new section.2
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:3
NEW SECTION. Sec. 1. The legislature finds that:4
(1) There is a severe shortage of primary care providers in 5
Washington, particularly in rural and underserved areas of the state;6
(2) A focus on primary care results in a health care delivery 7
system that is more productive and less expensive; and8
(3) The efficient and affordable use of primary care clinical 9
rotations and preceptorships could expand the supply of primary care 10
providers without burdening medical students who choose to provide 11
primary care with excessive debt. 12
Sec. 2. RCW 70.390.080 and 2022 c 155 s 1 are each amended to 13
read as follows: 14
(1) The board shall measure and report on primary care 15
expenditures in Washington and the progress towards increasing it to 16
12 percent of total health care expenditures. 17
(2) By December 1, 2022, the board shall submit a preliminary 18
report to the governor and relevant committees of the legislature 19
H-3775.1
HOUSE BILL 2748
State of Washington 69th Legislature 2026 Regular Session
By Representatives Dufault, Corry, Manjarrez, Mendoza, and Barnard
Read first time 03/05/26. Referred to Committee on Health Care &
Wellness.
p. 1 HB 2748
addressing primary care expenditures in Washington. The report must 1
include: 2
(a) How to define "primary care" for purposes of calculating 3
primary care expenditures as a proportion of total health care 4
expenditures, and how the definition aligns with existing definitions 5
already implemented in Washington, including the previous report from 6
the office of financial management and the Bree collaborative's 7
recommendations; 8
(b) Barriers to the access and use of the data needed to 9
calculate primary care expenditures, and how to overcome them;10
(c) The annual progress needed for primary care expenditures to 11
reach 12 percent of total health care expenditures in a reasonable 12
amount of time; 13
(d) How and by whom it should annually be determined whether 14
desired levels of primary care expenditures are being achieved;15
(e) Methods to incentivize the achievement of desired levels of 16
primary care expenditures; 17
(f)(i) Specific practices and methods of reimbursement to achieve 18
and sustain desired levels of primary care expenditures while 19
achieving improvements in health outcomes, experience of health care, 20
and value from the health care system, including but not limited to: 21
Supporting advanced, integrated primary care involving a 22
multidisciplinary team of health and social service professionals; 23
addressing social determinants of health within the primary care 24
setting; leveraging innovative uses of efficient, interoperable 25
health information technology; increasing the primary care and 26
behavioral health workforce; and reinforcing to patients the value of 27
primary care, and eliminating any barriers to access.28
(ii) As much as possible, the practices and methods specified 29
must hold primary care providers accountable for improved health 30
outcomes, not increase the administrative burden on primary care 31
providers or overall health care expenditures in the state, strive 32
for alignment across payers, and take into account differences in 33
urban and rural delivery settings; and 34
(g) The ongoing role of the board in guiding and overseeing the 35
development and application of primary care expenditure targets, and 36
the implementation and evaluation of strategies to achieve them.37
(3) Beginning August 1, 2023, the board shall annually submit 38
reports to the governor and relevant committees of the legislature. 39
To the extent possible, the reports must: 40
p. 2 HB 2748
(a) Include annual primary care expenditures for the most recent 1
year for which data is available by insurance carrier, by market or 2
payer, in total and as a percentage of total health care expenditure;3
(b) Break down annual primary care expenditures by relevant 4
characteristics such as whether expenditures were for physical or 5
behavioral health, by type of provider and by payment mechanism; and6
(c) If necessary, identify any barriers to the reporting 7
requirements and propose recommendations for how to overcome them.8
(4) In developing the measures and reporting, the board shall 9
consult with primary care providers and organizations representing 10
primary care providers and review existing work in this and other 11
states regarding primary care, including but not limited to the 12
December 2019 report by the office of financial management, the work 13
of the Bree collaborative, the work of the advancing integrated 14
mental health center and the center for health workforce studies at 15
the University of Washington, the work of the Milbank memorial fund, 16
the work of the national academy of sciences, engineering, and 17
medicine, and the work of the authority to strengthen primary care 18
within state purchased health care. 19
(5) The board shall review the cost of primary care 20
preceptorships for hospitals and other clinical settings to train 21
primary care physicians to address the need for primary care 22
providers in rural and unserved areas in Washington. By December 1, 23
2027, the board shall submit a report to the governor and relevant 24
committees of the legislature detailing its findings.25
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p. 3 HB 2748