Skip to main content

Making Care Primary: Do you need value-based care experience to apply?

making care primary

Are you a primary care practice that’s considering joining the Making Care Primary model? If so, you may have concerns about the experience needed to participate in a value-based care model. In this blog post, we’ll explore whether VBC experience is a requirement to apply for MCP and what benefits you can expect from the program, regardless of your experience level.

Is value-based care experience required for MCP?

Primary care providers don’t need VBC experience to apply for MCP. However, since MCP is a multi-state initiative, you do need to be located in one of the following states:

  • Colorado;
  • Massachusetts;
  • Minnesota;
  • New Jersey;
  • New Mexico;
  • New York;
  • North Carolina; or
  • Washington.

Note, in New York only upstate counties are included under the model. See Appendix D in the Making Care Primary Request for Applications for more information. 

Is there an advantage for practices with little to no VBC experience?

One of the key benefits of the model is that primary care providers who have no experience with VBC can come in at Track 1 (out of 3). This track is designed to help facilitate the operational setup of the program. Track 1 supports organizations as they build infrastructure and become capable of delivering accountable care. 

The Center for Medicare and Medicaid Innovation’s new MCP model means a lot for eligible providers with no previous VBC experience. It’s a major advantage for providers who are small, independent or rural or who support underserved populations and may not have the resources to invest in VBC themselves. Additionally, coming in at Track 1 means that you have the lowest level of potential financial risk for the first two and a half years of the model. During this time, practices will build the foundation needed to redesign their care delivery system and will expand upon that as the model progresses. 

MCP participation benefits providers should consider

In Track 1, providers can take advantage of an upfront infrastructure payment option. This is a time-limited, $72,500 payment that can be used to increase staffing, address patients’ social determinants of health needs or invest in health information technology. 

It’s worth noting that most alternative payment models don’t provide this type of start-up financial support. Historically, providers have had to make the needed practice transformation investments on their own. However, CMS is making it available to those who otherwise may not have the opportunity to explore VBC.

The three-track design of the MCP model means that providers who enter at Track 1 won’t enter Track 3 until the middle of the 10.5-year model. This allows for gradual changes in the required care delivery activities, payment methodology and performance criteria to take place.

Practices will also be able to leverage exclusive learning opportunities and events throughout the duration of the model to encourage the sharing of best practices and information dissemination.

Ultimately, participation in MCP will empower practices to deliver highly coordinated, patient-centered advanced primary care to their patients. 

Need help determining if MCP is right for you? Contact us.

VBC experience is not a requirement to apply for the MCP program. In fact, the program is designed to offer accessibility to providers of all sizes and experience levels. If you’re considering applying, schedule a time to speak with DataGen to discuss how MCP can elevate your care.

Our experts can help give you the robust data and guidance needed to apply and sustain your MCP participation — plus, we’ll even take you through a live demonstration of our performance monitoring analysis platform. In the meantime, read our blog, Making Care Primary Model: 5 crucial things to know, to learn everything you need to know about MCP. 

Labels:

Comments

Post a Comment

Popular posts from this blog

Five key components of a strong patient safety culture

In today’s healthcare environment, ensuring patient safety is more than just a priority — it’s a fundamental component of quality care. Establishing a strong patient safety culture within hospitals and health organizations can dramatically reduce errors, increase patient satisfaction and improve overall healthcare outcomes. But what exactly is a patient safety culture, and how can institutions cultivate it effectively?  This blog post explores the five key components that make up a robust patient safety culture, along with insights from the Agency for Healthcare Research and Quality (AHRQ) and The Joint Commission.  What is patient safety culture?  AHRQ defines patient safety culture as how an organization's culture supports and promotes patient safety. This can extend to multiple levels, from individual units to departments to system levels. The AHRQ patient safety culture survey encompasses the shared values, beliefs and norms of healthcare practitioners and staff that...
Post a Comment
Read more

NCQA PCMH 2025 annual reporting: Standards and guidelines

For practices recognized under the National Committee for Quality Assurance’s (NCQA) Patient-Centered Medical Home (PCMH) model, understanding and meeting the NCQA PCMH 2025 annual reporting requirements is critical to sustaining recognition.  NCQA continues to refine its NCQA PCMH standards and guidelines , emphasizing team structure, care continuity and data integrity. Here’s what your practice needs to do to stay compliant and ensure a smooth reporting process. This blog is a continuation of our piece back in July 2024, which listed three updates to NCQA PCMH's 2025 annual reporting requirements . What is NCQA PCMH?  The NCQA Patient-Centered Medical Home (PCMH) is a model of care that emphasizes care coordination, patient engagement and continuous quality improvement. The PCMH framework is designed to improve healthcare outcomes by fostering strong patient-provider relationships and enhancing team-based care.  Since its inception, the NCQA PCMH program has evolved to...
Post a Comment
Read more