Primary care is essential to the effective and efficient functioning of health care delivery, yet we face an impending crisis due in part to a dysfunctional payment system. The paper proposes a new payment model to replace fee-for-service. A comprehensive payment would support health information systems and teams essential to the delivery of comprehensive and coordinated care. In theory, expecting-and paying-primary care physicians to take greater responsibility for patients as they encounter the health care system should result in higher quality and lower costs. Field tests of the new approach are needed to test the hypothesis.