This review explores the state of primary care reform across Canada with an aim to elicit jurisdictions that have progressed primary care most innovatively through the last decade. To do this we use six criteria that are identified as necessary components for more effective and efficient primary care systems:

1. Development of new models of primary care facilitating access to interprofessional teams
2. Introduction of tight patient rostering to contain costs, and improve accountability and continuity of care
3. Requirement that primary care practices provide patients with a comprehensive range of after-hour (24/7) primary care services
4. Effective investment in, and use of, information communications technology accessible to both patients and providers
5. Changes in primary care physician remuneration to encourage greater continuity and quality of care
6. Health system organization changes producing health system alignment for greater physician accountability to patients and health systems

Four jurisdictions (Alberta, Manitoba, Ontario, and the Northwest Territories) were identified to have initiated the most ambitious efforts towards primary care reforms and are worthy of deeper study.