Institute CEO Dr. Eric Gayle co-authors an op-ed in New York Daily News

On April 13, Dr. Eric Gayle, President and CEO of the Institute for Family Health, co-authored an op-ed in the New York Daily News with Aparna Mekala, CEO of the Primary Care Development Association. In the piece, they argue in support of the Primary Care Investment Act, which would increase the share of health care spending devoted to primary care.

Albany must pass the Primary Care Investment Act

By Dr. Eric Gayle and Aparna Mekala

PUBLISHED: April 13, 2026 at 5:00 AM EDT

Primary care is the front door to our health care system. But in New York, that door is creaking on its hinges.

Primary care providers keep children healthy, help manage chronic conditions, and ensure older New Yorkers can age with dignity. Primary care is where mental health concerns are first identified, where diabetes is managed before it leads to amputation, and where high blood pressure is controlled before it becomes a stroke. And yet, we fund primary care like an afterthought.

Only 5-7% of total health care spending in the United States is devoted to primary care, despite the fact that primary care accounts for roughly 35% of all health care visits. High-performing health systems around the world invest closer to 10-12%. The difference shows up in better health outcomes, longer life expectancy, and lower costs.

More than 4.8 million New Yorkers live in federally designated primary care shortage areas. Across the state, doctors and nurses are stretched thin.

When patients can’t get an appointment with a primary care provider, they delay care. Conditions worsen. Small health problems become emergencies. Many patients turn to hospitals because they have nowhere else to go. Those visits cost far more than preventive care, and taxpayers ultimately foot the bill.

Preventable hospitalizations cost New York billions each year, and an emergency room visit can cost 10 times more than a primary care appointment.

The burden falls disproportionately on communities already facing health inequities. Black New Yorkers experience preventable hospitalizations at more than twice the rate of white residents, while Latino communities face significantly higher rates as well. Strengthening primary care is one of the most effective strategies to reduce these disparities.

The evidence for change is overwhelming. Adding just one primary care physician per 10,000 people is associated with 11% fewer hospital visits, 7% fewer surgeries, and 5.5% fewer emergency department visits.

Community health centers serve more than two million New Yorkers every year regardless of a patient’s ability to pay. These centers are among the most cost-effective parts of the health system, delivering high-quality care at lower cost while anchoring health services in communities that need them most.

Nearly 20 states have taken action to increase primary care investment. States such as Rhode Island, Oregon, Colorado, and Washington have adopted policies to rebalance health care spending toward primary care and prevention, and early results show improved access and slower cost growth.

New York can do the same through the Primary Care Investment Act, which would establish a framework to measure and gradually increase the share of health care spending devoted to primary care. This approach is not about increasing overall health care spending. It is about spending smarter by prioritizing prevention and keeping people out of the hospital.

With 33 co-sponsors in the Assembly and 21 in the Senate, this legislation is gaining traction and nearing a majority, but we can’t let that momentum slow. For those of us who work on the front lines, we see every day how strong primary care can keep patients healthier and address issues before they escalate into crisis.

New York prides itself on leadership. At a time when workforce shortages are deepening and health disparities remain stark, we should lead again — by investing in the part of the health system proven to improve health, reduce costs, and strengthen communities.

If New York truly wants a healthier, more equitable, and more fiscally responsible future, the path forward is clear: Invest in primary care.

Gayle is CEO of the Institute for Family Health. Mekala is CEO of the Primary Care Development Corp.

Read the full op-ed in the New York Daily News (with subscription).