On January 31, 2026 the Primary Care First (PCF) model officially concluded, marking the end of an important chapter for many organizations entering value-based care. For participants, PCF served as a practical on-ramp, supporting early adoption of alternative payment structures, care delivery transformation, and performance accountability.

With PCF now behind us, health care leaders face a pivotal question: what comes next?

The conclusion of PCF does not signal a retreat from value-based care. Many organizations invested significantly in care management infrastructure, data reporting capabilities, and provider engagement during the model. Walking away from that work now risks losing hard-earned progress. At the same time, moving too quickly into a new model without adequate preparation can create unnecessary financial and operational strain.

Evaluating the Path Forward

Former PCF participants have several viable paths forward. Each option carries different levels of risk, complexity, and operational demand, making thoughtful evaluation essential.

Key Timelines to Consider:

[Image here]

Options to Consider

• Transitioning into the Medicare Shared Savings Program (MSSP): A natural next step for organizations with experience managing attributed populations, meeting quality benchmarks, and beginning to assume financial accountability.
• Joining an existing Accountable Care Organization (ACO): An option that allows organizations to leverage shared infrastructure, analytics, and governance while continuing to advance value-based care without building a program from the ground up.
• Partnering or building value based care capabilities: Independent physician groups and smaller systems may pursue partnerships that provide care management, analytics, and contracting support while preserving local autonomy. Larger organizations with sufficient scale, capital, and operational maturity may choose to build their own model, recognizing the added governance, infrastructure, and financial risk involved.

Key Questions to Ask Before Committing to a Path

Pausing to assess readiness before committing is an intentional choice. Evaluating capabilities, risk tolerance, and unresolved gaps helps leaders select the right path and timing instead of defaulting to the next available option.

Before moving forward, organizations should ask a few defining questions:

• Are we prepared to take on financial risk?
• Do our clinical and care management efforts reliably influence cost and quality?
• Can providers act on timely, trusted data to change performance?
• Is accountability for clinical and financial results clearly defined?

A structured readiness assessment helps leadership teams answer these questions honestly and understand where capabilities truly stand.

Moving Forward Thoughtfully

The end of PCF is less about choosing the next program and more about whether the capabilities built under PCF can stand without guardrails as risk and accountability increase. Organizations that succeed will be those that identify and address gaps in infrastructure, data, and clinical workflows before taking on deeper risk, rather than assuming participation alone will drive results.

COPE Health Solutions supports organizations through a structured readiness assessment designed to evaluate whether MSSP, or another value-based pathway, is the right next step based on organizational goals, capabilities, and risk tolerance.

Contact us for more information at info@copehealthsolutions.com.