The Centers for Medicare and Medicaid Services (CMS) announced Thursday that it formed a new primary care model, which aims to improve the quality of primary care for patients and advance value-based arrangements.
The model, called the Making Care Primary Model, will focus on small, independent, rural and safety net organizations and assist them in entering value-based arrangements. It will offer primary care clinicians enhanced model payments and tools to help them provide higher quality care. It will also provide resources to help the clinicians “better coordinate care with specialists.” In addition, it will offer support for integrated care, giving the physicians an improved capability to address patients’ physical and behavioral health needs.
“The goal of the Making Care Primary Model is to improve care for people with Medicaid and Medicare,” said CMS Administrator Chiquita Brooks-LaSure in a news release. “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 Making Care Primary Model will be tested by the Center for Medicare and Medicaid Innovation from July 1, 2024, to December 31, 2034, in Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina and Washington.
There will be three domains of the model. The first is care management, in which participants will build their care management and chronic conditions self-management services. Then there is care integration, where the participants will improve their connections with specialty care physicians and use behavioral health screening and evaluation. Lastly, there is community connection, where participants identify and address health-related social needs among their patients and direct them to community resources.
Participants — which include federally qualified health centers, Indian Health Service facilities and Tribal clinics — will have three different tracks of the model that they can participate in based on their experience level with value-based care:
- Track 1 will focus on building the infrastructure for advanced primary care services by helping them review data, create workflows, find staff for chronic disease management and more.
- Track 2 will focus on implementing advanced primary care and helping participants partner with social service providers, implement care management services and screen for behavioral health conditions.
- Track 3 will focus on optimizing care and partnerships by using quality improvement frameworks, forming social services and specialty care partnerships, connecting with community resources and more.
In all three tracks, participants will receive enhanced payments, CMS said.
The new model will work toward CMS’ goal of having all Medicare beneficiaries and most Medicaid beneficiaries in value-based care arrangements by 2030.
“Ensuring stability, resiliency, and access to primary care will only improve the health care system,” said CMS Deputy Administrator and Center for Medicare and Medicaid Innovation Director Liz Fowler in a statement. “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.”
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