Making Care Primary: Medicare’s Latest Attempt at Value-Based Primary Care
Wasan Kumar, Bob Kocher, Eli Y AdashiAbstract
On June 8th, 2023, the Centers for Medicare and Medicaid Innovation (CMMI) announced the Making Care Primary (MCP) model, its latest attempt to transform primary care delivery for a value-based care payment system. The MCP is a decade-long multi-payer partnership with a voluntary risk-adjusted payment model for primary care organizations. It provides financial support for organizations to develop and implement a value-based care infrastructure and prospective payments per beneficiary for the delivery of primary care. The MCP consists of 3 tracks, ranging from lump sum infrastructure payments to a fully prospective payment model with one-sided risk. In turn, physicians need to meet a set criteria such as quality outcomes, health-related social needs (HRSN) screening and referral, and high-touch chronic care management.1 While MCP is a well-planned effort, it is likely to suffer from some of the same pitfalls as prior CMS attempts to revolutionize primary care and may therefore exert unintended effects on market consolidation.