AS SHE STEPS down after nearly three decades at the helm of Massachusetts Health Quality Partners, Barbra Rabson is still focused on the primary care crisis.

“Primary care has been underfunded and undervalued for years,” she said on The Codcast. “And in this country, what we really have is a sick care system, not a health care system.”

Rabson joined John McDonough of the Harvard TH Chan School of Public Health and Paul Hattis of the Lown Institute on the monthly Health or Consequences episode. Data gathered by MHQP over the years paints a clear picture of a primary health system wildly out of balance despite its critical importance, she noted.

“All the evidence points to the fact that primary care is the only specialty of the healthcare system that results in longer lives and more equity,” Rabson said.

Yet, just 6 cents of every dollar in health care spending in the state went to primary care in 2023, she noted. Fewer than 20 percent of all medical school graduates in Massachusetts end up practicing in primary care, she said, even though primary care makes up about 50 percent of all ambulatory visits in this country.

The primary care workforce is aging, is paid less than other specialists, and the lack of capacity is creating barriers for access.

Rabson is a member of the 25-member task force on primary care access established by Gov. Maura Healey last January, which is due to release additional recommendations in May on some of the “trickier” items.

The data dashboard launched in partnership with the independent state agency Center for Health Information and Analysis showed a “downward spiral” as the Covid-19 pandemic began raging, Rabson said. Digging into the crisis further revealed persistent problems attracting and keeping primary care physicians, who have been losing autonomy as large health care systems snap up smaller practices.

Pay discrepancy isn’t the only concern for Rabson – there is also a data discrepancy. Only 0.3 percent of national federal research dollars go into primary care, she said.

On a national level, she said, “we’re just not investing in the research we need to know, okay, how do we do a better job of this, how do we attract people, and how do we be more efficient?”

On the episode, Rabson reflects on MHQP’s mission and upcoming 30th anniversary gala (1:30), how Massachusetts stacks up on measurement and transparency in health data (15:30), and the supply chain problems for primary care physicians (17:30).