Introducing the Making Care Primary (MCP) Model: A New Era in Primary Care
On June 8, 2023, the Centers for Medicare & Medicaid Services (CMS) unveiled an exciting new initiative set to transform primary care—the Making Care Primary (MCP) Model. Slated to launch on July 1, 2024, this voluntary model aims to revolutionize care management and coordination, equipping primary care clinicians with the tools and partnerships necessary to address both medical and health-related social needs (HRSNs). This innovative model will be tested over 10.5 years in eight states: Colorado, North Carolina, New Jersey, New Mexico, New York, Minnesota, Massachusetts, and Washington.
A Comprehensive Approach to Primary Care
The MCP Model builds on the success of previous primary care initiatives, such as Comprehensive Primary Care (CPC), CPC+, Primary Care First (PCF), and the Maryland Primary Care Program (MDPCP). It is designed as a multi-payer model with three participation tracks that support primary care clinicians in delivering advanced care services. This structure allows for a gradual adoption of prospective, population-based payments while enhancing behavioral health integration and specialty care coordination.
Primary care clinicians, often the first line of defense in managing chronic conditions and overall wellness, will now have access to enhanced model payments, tools, and support. The MCP Model aims to reduce health disparities by leveraging community connections and improving care coordination with specialists. This approach ensures that patients receive comprehensive care tailored to their health goals and social needs.
The MCP Model’s Vision for Care Delivery
Care Management: MCP participants will enhance their care management services, focusing on chronic disease management, such as diabetes and hypertension, while aiming to reduce unnecessary emergency department visits.
Care Integration: In alignment with CMS’ Specialty Integration Strategy, MCP will strengthen connections between primary care and specialty care clinicians. This includes implementing evidence-based behavioral health screenings to improve overall patient care.
Community Connection: MCP participants will identify and address HRSNs, connecting patients to essential community resources and services. This holistic approach ensures that patients’ social needs, such as housing and nutrition, are met alongside their medical needs.
Model Design and Participation Tracks
The MCP Model offers three progressive tracks to accommodate participants with varying levels of experience in value-based care:
Track 1 – Building Infrastructure: Participants will develop the foundation for advanced primary care services, including risk stratification, workflow development, and HRSN screening. While maintaining fee-for-service payments, CMS will provide additional financial support to build care transformation infrastructure.
Track 2 – Implementing Advanced Primary Care: Building on Track 1, participants will partner with social service providers and specialists, implement care management services, and screen for behavioral health conditions. Payment will shift to a 50/50 blend of prospective, population-based payments and fee-for-service.
Track 3 – Optimizing Care and Partnerships: Participants will optimize workflows, address care silos, and deepen connections to community resources. Payment will shift to fully prospective, population-based payments, with continued financial support from CMS to sustain care delivery activities.
Eligibility and State Participation
To participate in the MCP Model, organizations must be legally authorized, Medicare-enrolled, and bill for health services to at least 125 Medicare beneficiaries. The majority of primary care sites must be located in an MCP state. Certain practices, such as Rural Health Clinics and concierge practices, are not eligible.
The eight selected states—Colorado, Massachusetts, Minnesota, New Mexico, New Jersey, New York, North Carolina, and Washington—were chosen based on geographic diversity, health equity opportunities, and alignment with state Medicaid agencies. CMS will provide further details about state-specific eligibility criteria in the upcoming Request for Applications (RFA).
How PharmD Live Can Support the MCP Model
At PharmD Live, we are uniquely positioned to support the MCP Model’s goals through our comprehensive medication management services and advanced telehealth solutions. Here’s how we can contribute:
- Enhanced Care Coordination: Our platform facilitates seamless communication between primary care clinicians, specialists, and behavioral health providers. This ensures that all members of a patient’s care team are aligned and informed, reducing the risk of miscommunication and enhancing overall care quality.
- Chronic Disease Management: We provide targeted support for managing chronic conditions such as diabetes and hypertension. Our clinical pharmacists work closely with patients to optimize medication regimens, monitor health outcomes, and provide education to improve self-management skills.
- Behavioral Health Integration: PharmD Live offers evidence-based screening and evaluation tools for behavioral health conditions. By integrating these services into primary care practices, we help clinicians address the full spectrum of patient needs, including mental health.
- Addressing Health-Related Social Needs: Our team collaborates with community resources to identify and address HRSNs such as housing, nutrition, and transportation. This holistic approach ensures that patients receive comprehensive support to improve their overall well-being.
- Value-Based Care Support: We assist primary care practices in transitioning to value-based care models by providing the necessary infrastructure, data analytics, and financial management tools. Our support helps practices achieve the quality and cost outcomes required for success in the MCP Model.
The Future of Primary Care
The MCP Model represents a significant step forward in creating a high-performing health system that prioritizes comprehensive, patient-centered care. At PharmD Live, we are excited about the potential of this model to enhance primary care delivery and improve health outcomes. By investing in primary care and fostering better integration with specialty and behavioral health services, the MCP Model aligns with our mission to drive equitable access to care and improved patient wellness.
We look forward to seeing the positive impact of this model on both clinicians and patients and are committed to supporting its success through our innovative approaches and dedicated services.
