Original Publish Date: July 11, 2023
On June 8, 2023, the Centers for Medicare and Medicaid Services (CMS) announced a new advanced primary care payment model in eight states that will begin accepting applications this summer. Dubbed the Making Care Primary (MCP) Model, the model will be open to primary care providers with limited or no value-based care experience, including:
The model will operate for 10 1/2 years beginning on July 1, 2024, in the following eight states:
Like other models tested by the Center for Medicare and Medicaid Innovation (CMMI), the goal is to reduce disparities in care and improve patient outcomes.
This model will help CMMI achieve its goal to have 100% of traditional Medicare beneficiaries and most Medicaid beneficiaries in accountable care arrangements by 2030.
CMS is working with the Medicaid agencies in each state and plans to engage commercial payors in the coming months to support care transformation across multiple payors. Commercial payors are encouraged to partner with CMS.
MCP participants will improve care delivery through a focus on three domains:
The requirements for an organization to participate in an MCP, according to CMS, are:
Rural Health Clinics, concierge practices, current Primary Care First (PCF) practices, current Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health (REACH) participant providers, and legacy Tribal FQHCs aren’t eligible for MCP.
After the model has been in place for six months, organizations won’t be able to participate in the Medicare Shared Savings Program and MCP at the same time.
MCP is a three-track model with the first track reserved for organizations with no prior value-based care experience.
Track One: Building Infrastructure
Track Two: Implementing Advanced Primary Care
Track Three: Optimizing Care and Partnerships
More technical details, including the financial methodology, will be released with the Request for Applications, later this summer. Information about the Medicaid payment methodologies will be provided by each respective State Medicaid agency.
We’re Here to Help
Moss Adams has extensive experience helping primary care providers evaluate and thrive in alternative payment models. We can help you determine whether MCP makes financial sense for your clinic, oversee the application process, and support your program planning and implementation for success with the model. To learn more, contact your Moss Adams professional.