New Making Care Primary model to start 10-year test in 2024

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A new model of primary care will undergo a 10-year test in hopes of strengthening patient care in smaller and independent primary care organizations.

The U.S. Centers for Medicare & Medicaid Services (CMS) announced the Making Care Primary Model (MCP) to begin in eight states in 2024.

“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 the agency’s announcement.

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

“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,” Brooks-LaSure 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.”

Better coordination

CMS aims to improve patient experiences and outcomes while reducing disparities in care.

Medicare and Medicaid patients struggle with multiple chronic diseases, such as diabetes and high blood pressure, and 40% of them see seven or more specialists a year.

“This makes managing care more complex,” according to CMS. “As a result, many patients receive fragmented care increasing their likelihood of hospitalization and worse health outcomes.”

MCP will provide “resources and data to help primary care clinicians better coordinate care with specialists,” according to CMS model highlights.

“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,” according to the model’s official description.

Model goals

CMS announced MCP will launch in Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington with three goals:

• Ensure 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.
• To improve the quality of care and health outcomes of patients while reducing program expenditures.

Three tracks

MCP will use a progressive three-track approach with enhanced payments for participants that have used value-based care and alternative payment models, according to CMS. Track One will focus on building infrastructure to support care transformation. Tracks Two and Three will include advance payments with bonuses based on participant performance.

The approach will support clinicians in the transition to value-based care, “furthering CMS’s goal to ensure 100% of traditional Medicare beneficiaries are in a care relationship with accountability for quality and total cost of care,” according to the MCP’s official description.

Apply to participate

The MCP application period will open in late summer 2023, with MCP to launch July 1, 2024. Applicants must meet eligibility criteria:

• Be a legal entity formed under applicable state, federal, or Tribal law authorized to conduct business in each state in which it operates.
• Be Medicare-enrolled.
• Bill for health services furnished to a minimum of 125 attributed Medicare beneficiaries.
• Have the majority (at least 51%) of their primary care sites (physical locations where care is delivered) located in an MCP state.