CMS Announces New Primary Care Model

Earlier this month, the Centers for Medicare & Medicaid Services (CMS) announced a new primary care model aimed to improve health outcomes and better enable coordinated care with specialists to ultimately provide more seamless, high-quality, whole-person care.
 

Called Making Care Primary (MCP), the program is a voluntary 10.5-year multi-payer model that will launch July 1, 2024, in eight states: Colorado, Massachusetts, Minnesota, New Mexico, New Jersey, New York, North Carolina and Washington. CMS is working with State Medicaid Agencies with future plans to engage private payers.

The MCP Model focuses on three domains: care management, care integration and community connection, and includes three tracks based on practices’ experience with value-based care:

Track 1 – Building Infrastructure: This is designed for organizations with no prior value-based care experience and will focus on developing the foundation for implementing advanced primary care services.

• Payment: Fee-for-service (FFS) with CMS providing additional financial support to help participants develop care transformation infrastructure.

•  Financial Rewards: Participants can start earning rewards for improving patient health outcomes.

Track 2 – Implementing Advanced Primary Care: The second track builds upon Track 1 requirements and layers on partnering with social service providers and specialists, implementing care management services and screening for behavioral health.

• Payment: Split 50/50 between FFS and population-based payments with continued financial support (lower than Track 1).

• Financial Rewards: Increased rewards for improved outcomes.

Track 3 – Optimizing Care and Partnerships: The final track expands on the first two via improved workflows, care integration and connections to community resources.

• Payment: Fully population-based payment with continued financial support (lower than Track 2)

• Financial Rewards: Increased rewards over Track 2 for improved outcomes.

Applications will open in late summer 2023. Read more from CMS here.