This brief examines primary care clinician participation in the Quality Payment Program (QPP), parsed by clinician type, clinician specialty, clinician practice location, and Advanced Alternative Payment Model (A-APM) or Merit-Based Incentive Payment System (MIPS) program participation. We found that approximately 10% of primary care clinicians participate in A-APMs and less than 30% of primary care clinicians participate in MIPS. Thus, nearly 60% of primary care clinicians are exempt from MIPS and do not participate in an A-APM. Metropolitan primary care clinicians are more likely to participate in A-APMs than nonmetropolitan primary care clinicians. To realize QPP goals of improved health outcomes and smarter spending, the Centers for Medicare & Medicaid Services (CMS) could consider QPP updates that specifically advance primary care clinician participation. Furthermore, CMS could develop A-APMs and programs that specifically include nonmetropolitan primary care clinicians.