Original ArticlesLeveraged Primary Care Lessons From the TrenchesSmithline, Neil MDAuthor Information Strativision LLC, Sausalito, California. Correspondence: Neil Smithline, MD, Strativision LLC, Sausalito, 100 Woodward Ave, Sausalito, CA 94965 (firstname.lastname@example.org). The author acknowledges the kind assistance of Linda Brady for her thoughtful input and review of the article.The author has served as a subcontractor to Mercer Health & Benefits and certain observations cited in this article stem from associated work.The author has disclosed that he has no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Journal of Ambulatory Care Management: April/June 2020 - Volume 43 - Issue 2 - p 120-124 doi: 10.1097/JAC.0000000000000325 Buy Metrics Abstract To support primary care physicians (PCPs) in managing populations of patients requires a reengineering of PCP practices, and a new, disruptive model of care management, with the seamless integration of the 2. That is our conclusion, having watched 7 Accountable Care Organizations (ACOs) with direct employer contracts provide care to employed populations over a period of 6 years. We have seen dramatic improvement in outcomes when an ACO provides the needed resources, tears down the silos, and interweaves care management with PCP practices. That is leveraged primary care. © 2020 Wolters Kluwer Health, Inc. All rights reserved.