FEATURE · POPULATION HEALTH MANAGEMENT
CMS Announces New MCP Model for Primary Care Coordination
By Mark Hagland T
he federal Centers for Medicare & Medicaid Services (CMS) on Thursday, June 8 announced the
establishment of an entirely new alter- native payment model (APM), with the intention of improving care management and care coordination in primary care, for patients being cared for across both Medicare and Medicaid. In a press release posted to its web-
site, the agency announced that, “Today, the Centers for Medicare & Medicaid Services (CMS) announced a new primary care model – the Making Care Primary (MCP) Model – that will be tested under the Center for Medicare and Medicaid Innovation in eight states. Access to high-quality primary care is associated with better health outcomes and equity for people and communities. MCP is an important step in strengthening the pri- mary care infrastructure in the country, especially for safety net and smaller or independent primary care organiza- tions. The 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.” The agency stated that “The goals of
MCP are to 1) ensure patients receive primary care that is integrated, coordi- nated, person-centered and accountable; 2) create a pathway for primary care orga- nizations and practices – especially small,
independent, rural, and safety net orga- nizations – to enter into value-based care arrangements; and 3) to improve the qual- ity of care and health outcomes of patients while reducing program expenditures.” Further, “The MCP Model will
provide participants with additional revenue to build infrastructure, make primary care services more accessible, as well as better coordinate care with specialists. CMS expects this work to lead to downstream savings over time through better preventive care and reducing potentially avoidable costs, such as repeat hospitalizations. MCP will run for 10.5 years, from July 1, 2024, to December 31, 2034. The model will build upon previous primary care mod- els, such as the Comprehensive Primary Care (CPC), CPC+, Primary Care First models, and the Maryland Primary Care Program (MDPCP).” To that end, “CMS will test this advanced primary care model
in
Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington. CMS will work with model participants to address priorities specific to their com- munities, including care management for chronic conditions, behavioral health services, and health care access for rural residents. CMS is working with State Medicaid Agencies in the eight states to engage in full care transformation across public programs, with plans to engage private payers in the coming months. The model’s flexible multi-payer alignment strategy allows CMS to build on existing
30
hcinnovationgroup.com | JULY/AUGUST 2023
state innovations and for all patients served by participating primary care clinicians to benefit from improvements in care delivery, financial investments in primary care, and learning tools and supports under the model.” “The goal of the Making Care
Primary Model is to improve care for people with Medicaid and Medicare,” CMS Administrator Chiquita Brooks- LaSure said in a statement included in the announcement. “This model is one more pathway CMS is taking to improve access to care and quality of care, espe- cially to those in rural areas and other underserved populations. This model focuses on improving care manage- ment 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 press release noted that “Strong
relationships with primary care teams are essential for patients’ overall health. Primary care clinicians provide preventive services, help manage chronic conditions, and coordinate care with other clinicians. By investing in care integration and care management capabilities, primary care teams will be better equipped to address chronic disease and lessen the likelihood of emergency department visits and acute care stays, ultimately lowering costs of care. This model will support participants with varying levels of experience with
33572616 © Tashatuvango |
Dreamstime.com
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36
