The Centers for Medicare & Medicaid Services (CMS) has announced a new primary care model called the Making Care Primary (MCP) Model. This model will be implemented and tested in eight states through the Center for Medicare and Medicaid Innovation. The MCP Model aims to enhance the primary care infrastructure in the United States, particularly for safety net organizations and smaller or independent primary care providers. By expanding care management, care coordination, and community-based connections, the model seeks to improve patient care and outcomes.
The MCP Model has three main goals. First, it aims to ensure that patients receive integrated, coordinated, person-centered, and accountable primary care. Second, it aims to provide a pathway for primary care organizations, especially those that are small, independent, rural, or safety net providers, to enter into value-based care arrangements. Lastly, the model intends to enhance the quality of care, improve health outcomes, and reduce program expenditures.
Participants in the MCP Model will receive additional revenue to invest in infrastructure, improve accessibility to primary care services, and enhance care coordination with specialists. CMS anticipates that these efforts will result in long-term savings by promoting preventive care and reducing avoidable costs such as hospital readmissions. The MCP Model is scheduled to run for 10.5 years, starting from July 1, 2024, to December 31, 2034. It will build upon previous primary care models such as the Comprehensive Primary Care (CPC), CPC+, Primary Care First, and the Maryland Primary Care Program.
The MCP Model will be tested in the following eight states: Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington. CMS will collaborate with model participants to address community-specific priorities such as chronic condition management, behavioral health services, and healthcare access for rural residents. CMS is also working with State Medicaid Agencies in these states to facilitate full care transformation across public programs, and there are plans to involve private payers in the future. The model’s flexible multi-payer alignment strategy allows for building upon existing state innovations, ensuring that all patients served by participating primary care providers benefit from improved care delivery and financial investments in primary care.
CMS Administrator Chiquita Brooks-LaSure emphasized that the Making Care Primary Model aims to enhance care and access for individuals covered by Medicaid and Medicare, with a particular focus on underserved populations and rural areas. The model prioritizes care management, care coordination, partnerships with healthcare specialists, and collaborations with community-based organizations to empower individuals in managing their health conditions and achieving their health goals.
Investing in primary care teams and fostering strong relationships with patients is vital for overall health improvement. Primary care clinicians offer preventive services, manage chronic conditions, and coordinate care with other healthcare providers. By prioritizing care integration and management capabilities, primary care teams can better address chronic diseases, reduce emergency department visits, and minimize acute care stays, ultimately leading to cost reductions. The MCP Model supports participants with varying levels of experience in value-based care, including Federally Qualified Health Centers (FQHCs) and physician practices, with the aim of reducing disparities in care and achieving better patient experience and outcomes.
Liz Fowler, CMS Deputy Administrator and Director of the Center for Medicare and Medicaid Innovation, emphasized that the Making Care Primary Model represents a significant investment in the nation’s primary care network. The model’s progressive three-track approach, based on participants’ experience with value-based care and alternative payment models, will provide enhanced payments to participants across all tracks. Track One will focus on infrastructure development, while Tracks Two and Three will offer additional payment opportunities based on participant performance. This approach supports clinicians as they transition to value-based care, aligning
For more information about the CMS multi-state initiative to strengthen primary care, please visit the official CMS press release at: [source: CMS Newsroom – CMS Announces Multi-State Initiative to Strengthen Primary Care]