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Urge Your Lawmakers to Support Essential Health System Designation

CMMI to Test New Primary Care Model

Faridat Animashaun
June 13, 2023

The Center for Medicare & Medicaid Innovation (CMMI) announced on June 8 plans to test in eight states a new primary care model that aims to enhance access and quality of primary care.

Running from July 2024 through 2034, the Making Care Primary (MCP) Model will provide participants with additional revenue to build infrastructure, make primary care services more accessible, and better coordinate care with specialists. CMMI will test the model in Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington. MCP will build upon previous primary care models, such as the Comprehensive Primary Care (CPC), CPC+, and Primary Care First models, as well as the Maryland Primary Care Program.

MCP aims to invest in care integration and care management capabilities to better equip primary care teams to mitigate chronic conditions and lessen the likelihood of emergency department visits and acute care stays, ultimately lowering costs of care. The agency will collaborate with model participants to target priorities specific to their patient populations, such as behavioral health services.

The model also will further federal efforts to improve health equity. It includes adjustments to payments based on clinical indicators and social risk, strategic plans to identify and reduce disparities, implementation of health-related social needs (HRSN) screening and referrals, and reduced cost-sharing for patients in need. The Centers for Medicare & Medicaid Services (CMS) will measure the percentage of patients screened for HRSN and collect demographic and HRSN data to evaluate health disparities in MCP communities.

Additionally, the model includes a three-track approach based on participants’ level of experience with value-based care and alternative payment models:

  • Track one focuses on building infrastructure to support care transformation.
  • Tracks two and three will include advance payments and other opportunities for bonus payments based on performance.

Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.

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