CMS announces goals for primary care physicians, clinicians to provide better coordination of care for chronic diseases.
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 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.
“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.”
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.
CMS announced MCP will launch in Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington with three goals:
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.
The MCP application period will open in late summer 2023, with MCP to launch July 1, 2024. Applicants must meet eligibility criteria: