The 1978 Declaration of Alma-Ata is a turning point in history of global health stating primary healthcare is essential to achieve universal health coverage. Hospitals can play a supportive role and help primary health care to reach its objectives. It requires hospital systems and primary health care to collaborate. In a context of social, economic and clinical changes over the past 40 years, hospitals need a renewed vision, and policies have to be shaped to drive their transformation. This brief identifies key policy levers and intervention at the organizational level illustrated by interventions implemented globally in different contexts.