Primary care, the foundation of the state’s health care industry, is crumbling, and Massachusetts is running out of time to fix it, according to a report published Thursday by the state’s Health Policy Commission, which sounded the alarm on many ways the front door to the health care industry is broken.

Among the problems: high and growing rates of residents reporting difficulty accessing primary care; an aging and increasingly dissatisfied physician workforce; and an anemic pipeline of new clinicians.

“I worry when I look at some of this data that the state of primary care has crossed a line from which recovery will be very difficult, unless we take action soon,” the commission’s executive director, David Seltz, said in an interview.

The report sets the stage for the work of a new state-appointed primary care task force, created by a health care law signed earlier this month. The law outlines that the new 25-member group will consider issuing recommendations related to increasing recruitment and retention of the primary care workforce and establishing a target for how much insurers should spend on primary care.

Such goals would put Massachusetts more in line with other states, including California, Oregon, Rhode Island, and Washington, which have set benchmarks for primary care spending. Seltz called such efforts an important way to rebalance the incentives of the market.

“This is an opportunity to shift the dialogue, to one of: ‘What can we do immediately to relieve this deep challenge?’” Seltz said.

While the findings set the stage for reform, they are perhaps not a surprise. Previous reports on primary care have been blaring the warning signal for years. Increasingly high portions of residents have said they had difficulty accessing health care. Analysis on health care spending has shown dwindling amounts of health care dollars going to primary care.

But the report lays out in stark terms just how dire the prognosis on primary care is.

Among the findings:

• Patients’ ability to access primary care is bad and getting worse. New patients must wait an average of 40 days in Boston, twice as long as the average of 15 other cities studied. Access to primary care worsened across the state in recent years, with such issues especially pronounced in lower-income communities.
• A lack of primary care access means more reliance on emergency departments, which are more costly places to get care. In 2023, a whopping two-thirds of those who sought care in hospitals’ emergency departments said they were there because they couldn’t get an appointment in a doctor’s office or clinic.
• Massachusetts has a lot of doctors — the highest total physicians per capita in the country. However the vast majority of those physicians are specialists. Compared to other states, Massachusetts has the fifth lowest share of primary care physicians.
• The primary care workforce is aging, with an estimated half of primary care physicians over the age of 55.
• The pipeline for new primary care doctors is dwindling, with only one in seven new Massachusetts physicians in 2021 going into primary care — among the lowest share in the country.

A primary driver of the current challenge is related to the low reimbursement rates primary care receives relative to other specialties and hospital services, the report states, a factor that disincentivizes both new graduates from entering the field and the health care industry from investing in it.

Beyond the low pay, primary care can be an exhausting job, requiring myriad billing and administrative tasks, increased documentation requirements, and visits too short to accommodate the core point of primary care — caring for the patient.

Dr. Alecia McGregor, a commissioner and an assistant professor at the Harvard T.H. Chan School of Public Health, noted the state is seeing evidence of that very burnout and corporatization of medicine, with both those complaints cited as key reasons primary care doctors at Mass General Brigham recently filed to unionize.

The state is currently making up for primary care physician shortages by leaning more on nurse practitioners and physician assistants, together known as “advanced practice providers.” However the share of even those providers working in primary care is dropping, in part because of the low pay.

“Relying on advanced practice providers to serve as (primary care providers) instead of physicians may not resolve challenges related to the availability of providers if we can’t improve job sustainability in the field of primary care,” said Sasha Albert, associate director of research and cost trends at the Health Policy Commission, during a presentation at Thursday’s commission meeting.

Beyond setting the stage for a new task force, Commissioner Tim Foley said the “scary” report emphasized the importance of the commission remaining focused on drivers of the recruitment and retention challenges.

“It just highlights again our need to continue to focus on the workforce issues,” said Foley, who is also the head of union 1199SEIU, which represents health care workers. “We had the hearing on the impact of the workforce, and it hasn’t gotten any better. It’s probably gotten worse.”

Jessica Bartlett can be reached at jessica.bartlett@globe.com. Follow her @ByJessBartlett.

Fall River Mayor Paul Coogan is up for re-election this fall. If it seems the Spindle City is in a perpetual state of campaigning, it is.

Like all Massachusetts cities with elected mayors, Fall River has a municipal election every two years. New Bedford does as well.

However, while Fall River elects a mayor every other year, mayoral elections are held every four years in New Bedford.

City councilors, school committee members, and other elected municipal officials in both cities face re-election every two years, thus the perception that they are always campaigning.

Of the 351 communities in Massachusetts, 47 have elected mayors. Twenty-four (51 percent) of them have four-year mayoral terms. Twenty-three (49 percent) have two-year terms.

For most of its history, New Bedford had two-year mayoral terms. In 2017, voters narrowly approved a ballot question extending New Bedford’s mayoral term to four years.

There was a time when New Bedford held mayoral elections annually.

Mayor Jon Mitchell, first elected Mayor of New Bedford in 2011, was the first to win the new four-year term in 2019. In 2023, Mitchell won a second four-year term. Mitchell has not indicated if he plans to seek a third four-year term when his current term is up in 2027.

Mitchell told WBSM as far back as 2013 that he favored a four-year term, calling the two-year term “archaic.”

In 2017, Mitchell told WBSM, “Running the City of New Bedford is not like running a lemonade stand.” Mitchell said a two-year term forces more short-term decisions than long-term ones.

The Massachusetts Municipal Association’s website lists all current Massachusetts mayors, the length of their term, and when their term expires.

The man allegedly lured by the Assumption University students was a 22-year-old active military member.

The six Massachusetts college students accused of participating in the “catch a predator” TikTok trend by using Tinder to lure a man to campus and assaulting him appeared in court Thursday as they were arraigned.

The Assumption University students, who all face kidnapping and conspiracy charges, briefly stood in Worcester District Court and pleaded not guilty before being released on personal recognizance.

The accused students all exited the courtroom hastily with their families and none of them, or their attorneys, offered comment to reporters following the brief hearings, according to the Worcester Telegram & Gazette − part of the USA TODAY Network.

The defendants — Kelsy Brainard, 18; Easton Randall, 19; Kevin Carroll, 18; Isabella Trudeau, 18; and Joaquin Smith, 18 — showed little emotion in the courtroom, the Associated Press reported. A juvenile was also charged and arraigned separately in juvenile court, the outlet said.

Robert Iacovelli, Trudeau’s lawyer, told the Worcester Telegram & Gazette his client is innocent and he subsequently filed a one-page motion on Thursday seeking dismissal of the charges against her arguing the authorities’ lack of probable cause.

USA TODAY contacted the students’ attorneys Thursday but did not receive an immediate response.

Here is what to know about the case and the man who campus police say was falsely labeled a sexual predator.

What are the Assumption University students accused of doing?

The Assumption University students are accused of using Tinder to trick the man to the school’s campus on Oct. 1, and once there, he was mobbed by a group of more than 20 students who called him a pedophile and assaulted him, according to a criminal complaint obtained by USA TODAY.

Although Brainard told campus police that the “creepy guy” came on campus looking for a 17-year-old girl, officers found no evidence of this and said she and the other five students fabricated the meetup to participate in the “catch a predator” TikTok trend.

The man “believed he was meeting an 18-year-old girl on a college campus and using the Tinder app as it is originally designed to initiate a hookup,” the complaint reads. Brainard’s Tinder account also listed her as 18, police said.

What did the university say?

In response to the subsequent investigation and charges against its students, the university’s President Greg Weiner said in a statement to USA TODAY that “the behavior described in the court filing is abhorrent and antithetical to Assumption University’s mission and values.”

Assumption University is a private, Catholic university located in Worcester, Massachusetts.

“In all circumstances, we expect our students to exercise sound judgment and uphold the principles of respect, responsibility, and character that define our community,” Weiner said. “Once the incident was reported, the Department of Public Safety commenced an immediate and thorough investigation − with concern for the victim at the forefront − which resulted in our Campus Police filing charges against six students.”

The school did not say whether or not the students would face academic discipline.

Alleged victim was a 22-year-old active military member

The man who was mobbed and assaulted, including having his head slammed into his car door allegedly by the juvenile student, is a 22-year-old active military member.

“This situation is particularly sobering because the victim is an active-duty military service member,” Weiner said. “His service reminds us of the sacrifices made by those who defend our freedoms, including the opportunity to pursue a college education.”

The man told police he was in Worcester for his grandmother’s funeral in October and “just wanted to be around people that were happy,” according to the complaint.

Before leaving the courtroom, the judge ordered the teenagers to not have any contact with the man, the AP reported.

What is the ‘catch a predator’ trend?

The “catch a predator” TikTok trend is inspired by the popular reality TV series “To Catch a Predator” featuring journalist Chris Hansen. The show aired on NBC and revolved around men arriving at a sting house to try and have sex with a minor. The men were usually ambushed at the homes by Hansen and law enforcement before being arrested.

Sometimes these vigilante-like operations lead to convictions, but usually, they do not. Authorities have warned people against conducting these stings because they could turn violent.

“We are asking parents to take these incidents as an opportunity to talk with their teenage children about the seriousness of actively participating in these types of trends they see on social media,” Mount Prospect, Illinois Police Chief Michael Eterno said after 11 teenage boys were charged with felonies last year for allegedly participating in the trend.