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. 


Popular posts from this blog

Unlock the Potential of Value-based Payment

A common misconception in healthcare practices: Organizations can quickly reap the benefits of value-based payment transformation. To launch a successful value-based payment program , practices must implement a variety of foundational pieces. It may take time, resources and data before a practice can successfully engage in VBP. In this blog, we'll cover what goes into VBP and its potential benefits. We'll also dig deeper into practice advancement strategies and how they can help you achieve your practice goals. What goes into VBP? Many practices want to implement VBP because of its payment structure and return on investment. Yet, they might not consider how to nurture a successful VBP program in their organization. It starts with a gap analysis regarding people, processes and technologies. It’s important to celebrate what is working well and intervene where improvement can be made. Successful VBP starts with the practice team. There are many perceptions vs. realities that exist

BPCIA: 4 fast facts for a successful Model Year 7 kickoff

Participation in Model Year 7 launched on Jan. 1, 2024, with the first few months being a critical time for providers. New Bundled Payments for Care Improvement Advanced Model (BPCIA) participants got their footing, and continuing participants were able to change their clinical episode service line groups for the first time since 2020.  If you’re a provider participating in this model, read on for a BPCIA refresher and four fast facts for starting MY7 right. We’ll also cover core analytics activities to support your clinical and operational success.   4 Fast facts on BPCIA Model Year 7  1.   Focus on clinical episodes and episode volume  Before MY7 began, providers used historic baseline data provided by CMS to evaluate which CESLGs they would go at risk for, ensuring there would be sufficient episode volume. Large episode volume (100 episodes/year or more) reduces random variation and helps protect providers from financial risk associated with outlier Medicare episode spend.    During