top of page
Newspapers

NEWS & EVENTS

  • Writer's pictureElizabeth Welch

CMMI's Making Care Primary (MCP) Model

For those who missed the headlines, the Center for Medicare and Medicaid Innovation (CMMI) recently announced the Making Care Primary (MCP) Model. Launching in July of next year, MCP is a 10.5-year model that aims to usher primary care systems into value-based care arrangements. This “unprecedented investment in our nation’s primary care network,” according to CMMI director Liz Fowler, will bring the Centers for Medicare and Medicaid Services (CMS) closer to achieving their goal of having 100% of Medicare, and the majority of Medicaid, beneficiaries in value-based care relationships by 2030.


Later this summer, MCP applications will open to Medicare-enrolled organizations located in the eight participating states. Building upon previous CMMI primary care models, MCP will focus on care management, care integration, and community connection in order to improve outcomes while, eventually, reducing long-term costs of care. In other words, these increasingly familiar pillars are tasked with driving the “value” in value-based care. Notably, however, MCP will go a step further than simply (or, rather, not so simply) developing this clinical infrastructure in participating hospitals: enabled by these value-driving tools, participants will be transitioned from fee-for-service (FFS) payment to prospective, population-based payments. MCP will thereby provide the on-ramp for participating primary care organizations to actually implement value-based, alternative payment models (APMs).


MCP is designed as a three-track phased program built for a range of different resource settings, from organizations unfamiliar with APMs to those already engaged in APMs. At a birds-eye view, Track 1 (“Building Infrastructure”) provides financial and strategic support to participants to develop care transformation infrastructure, including chronic disease management, health-related social needs (HRSN) screenings, and population risk-stratification. Although participants on this track will remain in FFS arrangements, they can begin earning financial rewards for improving patient health outcomes.


As participants transition to Track 2, ("Implementing Advanced Primary Care"), they will deepen their care transformation tools (with sustained but lessened CMS financial support) while shifting to a 50/50 combination of FFS and prospective, population-based payments. Finally, participants in Track 3 (“Optimizing Care and Partnerships”) will continue to advance their care delivery, management, and integration services based on quality assessments. As they deliver further value, payment will shift to fully prospective, population-based payments with increased rewards for improved outcomes. All the while, MCP will address health equity by, for example, adjusting payments based on social risk, tasking participants to implement HRSN screenings and develop strategies to reduce disparities, and even reduce cost-sharing for patients in greater need.


Although we must wait a year for kick-off, MCP marks a crucially important step in the US health system’s probable, and long-awaited, shift to value-based APMs. Putting our investor hat on, we’ll be on the lookout for companies facilitating and streamlining these processes, from population-based risk-stratification to outcomes assessments for quality benchmarking.


Looking to learn more about how CMMI initiatives may affect your business? Brooks Hill Partners is a life sciences consultancy and early-stage health tech venture capital firm that partners with passionate companies across the biopharma and healthcare landscape. Please contact us to learn more about how we can help you today. For more information, visit https://www.brookshillpartners.com/ and follow us on LinkedIn.  


Sources

コメント


Interested in learning more?

Are you a health tech founder?

bottom of page