New CMS multi-state initiative to test out value-based primary care
The Centers for Medicare & Medicaid Services’ new initiative will focus on primary care organizations, especially in rural areas, with limited experience in alternative payment models to help set up infrastructure.
Access to high-quality primary care contributes to better health outcomes and equity for people and communities. The Centers for Medicare & Medicaid Services announced that it will seek to improve access by testing the new Making Care Primary model in eight states
“The goal of the Making Care Primary Model is to improve care for people with Medicaid and Medicare,” CMS Administrator Chiquita Brooks-LaSure said. “This model is one more pathway CMS is taking to improve access to care and quality of care, especially to those in rural areas and other underserved populations. This model focuses on improving care management and care coordination, equipping primary care clinicians with tools to form partnerships with health-care specialists and partnering with community-based organizations, which will help the people we serve with better managing their health conditions and reaching their health goals.”
The voluntary primary care model seeks to improve care for patients by expanding and enhancing care management and care coordination, equipping primary care clinicians with tools to form partnerships with health-care specialists and leveraging community-based connections to address patients’ health needs, as well as their health-related social needs. It has three objectives:
- Ensure that patients receive primary care that is integrated, coordinated, person-centered and accountable;
- Create a pathway for primary care organizations and practices — especially small, independent, rural and safety-net organizations — to enter into value-based care arrangements; and
- Improve the quality of care and health outcomes of patients while reducing program expenditures.
CMS will test this model in Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina and Washington. The agency will work with model participants to address priorities specific to their communities, including care management for chronic conditions, behavioral health services and health-care access for rural residents.
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“Ensuring stability, resiliency and access to primary care will only improve the health-care system,” CMS Deputy Administrator Liz Fowler said. “The Making Care Primary Model represents an unprecedented investment in our nation’s primary care network and brings us closer to our goal of reaching 100% of traditional Medicare beneficiaries and the vast majority of Medicaid beneficiaries in accountable care arrangements, including advanced primary care, by 2030.”
Primary care organizations within participating states may apply when the application opens late this summer, and the model will launch on July 1, 2024 and run until Dec. 31, 2024. CMS has set a goal of having every Medicare beneficiary in a value-based care relationship by 2030.