There is renewed focus on the role of primary care and preventive health in U.S. healthcare. Primary care is widely accepted as the gatekeeper for essential services provided by hospitals and specialists. It also serves as the principal vehicle to reduce the cost of chronic disease treatment and management. As a result, primary care delivery has evolved to include integrated physical and mental health services, prophylactic dentistry, nutrition, health coaching, over-the-counter and prescription drug dispensing, and more, with services accessible through modern physical locations and digital networking. This article explores changes to and trends in primary care delivery and why competing in primary care requires hospitals, health systems, and physician organizations to take a fresh look at their strategic positioning in a broader context.