The Making Care Primary Opportunity

As CMS moves to have all Medicare beneficiaries under some type of value-based care arrangement by 2030, and as more work is done to address health equity and access for underserved populations, CMMI is introducing a demonstration model aimed at empowering primary care providers to build collaboration with specialists and address patients’ health and social needs. The Making Care Primary (MCP) Model is an opportunity for home-based, post-acute care providers to build their partnerships with primary care providers and move their care further and further upstream. 

The MCP Model will be launched in July of 2024 and will continue over the next 10 years. At this point, MCP will only be available in 8 states, which are Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington. MCP will support providers through 3 tracks. The first is building infrastructure, including building risk-stratification, data analysis, health-related social needs screening and more, during which CMS will provide financial support and rewards for improved patient outcomes. The second is partnering with social service providers and specialists, implementing care management, and behavioral health screening, during which CMS will start providing population-based payments, as well as lower infrastructure supports and increased rewards for outcome. The third is optimizing care through quality improvement, increasing care integration, and strengthening partnerships with social service providers and specialists, during which CMS will move to full population-based payments, lower infrastructure support, and greater rewards for improved patient outcomes. 

The RFA for MCP will be released this fall and we will then learn many of the important details. For home-based, post-acute care providers such as hospice and palliative care providers and home health agencies, the true opportunity in MCP lies with the requirement to build partnerships with specialists. Especially since home-based, interdisciplinary serious illness care will drive many of the patient outcomes incentives that MCP providers will be focusing on, this will be a great opportunity for such providers to forge alliances with primary care to drive upstream care service lines. Acclivity is already working with primary care providers to make the most of MCP. If you are in a targeted state, do not miss this opportunity. 

Source Material:

“Making Care Primary (MCP) Model” on CMS’ Innovation Center Home and accessible at https://innovation.cms.gov/innovation-models/making-care-primary