CMS encourages physicians to apply for new Making Care Primary model

© STOATPHOTO - stock.adobe.com

Medicare leaders and family physicians will join for an information session about a new health care model that will start next summer.

This year, the U.S. Centers for Medicare & Medicaid Services (CMS) announced Making Care Primary (MCP), a new model that will launch in July 2024 in eight states for 10.5 years. CMS is encouraging physicians to begin making applications that are due Nov. 30 to be considered for the model, which will start in Colorado, North Carolina, New Jersey, New Mexico, New York, Minnesota, Massachusetts and Washington.

MCP is geared to smaller, independent organizations that want to participate in value-based care independently, instead of joining with a broader entity. CMS, the American College of Physicians, the American Academy of Family Physicians, and the American Medical Association will join to host a webinar on Making Care Primary. The webinar is scheduled for 7 p.m. Sept. 27, with advance registration and question submission online.

Chiquita Brooks-LaSure
_{U.S. Centers for Medicare & Medicaid Services}

“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 this year’s announcement.

“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,” she said. “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.”

CMS’ model purpose states physicians and other clinicians will deliver care through three domains:

• Care management, emphasizing diabetes, hypertension, and reducing unnecessary emergency department use.
• Care integration, strengthening connections with specialists and integrating behavioral health screenings.
• Community connections, identifying patient health-related social needs and connecting patients to community supports and services.

Over time, participating practices may work through three tracks, starting with building infrastructure. In Track 2, participants will implement advanced primary care, with a 50/50 blend of prospective, population-based payments and fee-for-service payments.

Track 3 will emphasize care integration with social services, specialty partnerships and community resources, with payment shifting fully to prospective, population-based payment.

“Primary care clinicians are the first line of defense for prevention, screening, management of chronic conditions, and overall wellness,” CMS said in the description of the model purpose.
“Patients are increasingly diagnosed with multiple chronic conditions, which only intensifies the importance of accessible, affordable, high-quality primary care teams that can help anchor their overall health care,” the model purpose said. “However, care coordination is increasingly challenging as patients see a greater number of specialists more frequently. Through MCP, the Center for Medicare and Medicaid Innovation (the Innovation Center) increases the investment in primary care so patients can access more seamless, high-quality, whole-person care.”

CMS has a webpage dedicated to Making Care Primary, with an introductory video, fact sheets, and summaries of events held so far to explain the new model.