The U.S. Centers for Medicare & Medicaid Services (CMS) unveiled a new primary care alternative payment model on Thursday – giving behavioral health care a key shoutout in the process.
The Making Care Primary (MCP) Model will test advanced approaches to primary care in eight initial states: Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina and Washington. It will run for 10.5 years, from July 1, 2024, to Dec. 31, 2034.
“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,” CMS Deputy Administrator and Center for Medicare and Medicaid Innovation (CMMI) Director Liz Fowler said in a statement.
MCP is one of the many alternative payment models in CMMI’s portfolio.
Broadly, the new model is designed to give participants added revenue to improve their programs and form more coordinated care arrangements with specialists. With primary care and specialty providers working hand in hand, CMS believes the model will “lead to downstream savings over time through better preventive care.”
Behavioral health is among the focus areas that CMS identified.
“CMS will work with model participants to address priorities specific to their communities, including care management for chronic conditions, behavioral health services and health care access for rural residents,” the agency wrote in an announcement.
The new model builds upon previous primary care models, such as the Comprehensive Primary Care (CPC), CPC+ and Primary Care First models, and the Maryland Primary Care Program (MDPCP).
The new MCP model will have three tracks for participating primary care groups.
Track 1 will focus “on building infrastructure to support care transformation,” according to CMS. Tracks 2 and 3 will include certain advance payments and offer more opportunities for bonus payments based on participant performance.
By Track 3, payment for primary care will graduate to fully prospective, population-based payment.
“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 Administrator Chiquita Brooks-LaSure said in a statement.
CMS will begin accepting applications for the model in late summer 2023.
Many behavioral health providers have worked to make value-based care inroads with private insurers and employee assistance programs (EAPs). But risk-taking primary care providers are another pathway to value-based care, and the launch of MCP could accelerate that trend.
“The MCP Model will provide a pathway for primary care clinicians with varying levels of experience in value-based care to gradually adopt prospective, population-based payments while building infrastructure to improve behavioral health and specialty integration and drive equitable access to care,” a CMS fact sheet on the model explains.