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Making Care Primary Model is Launching Soon: What's Next?

Doctor talking to patient

The healthcare landscape is evolving rapidly, presenting primary care practices with various challenges. In fact, CMS’ Making Care Primary (MCP) model is launching on July 1, 2024, requiring practices to thoroughly understand its patient population, financial drivers and care outcomes. 

The Making Care Primary model, lasting 10+ years, aims to: 

  • improve care management and care coordination;

  • equip primary care clinicians with tools to form partnerships with health care specialists; and

  • leverage community-based connections to address patients’ health needs and their health-related social needs (HRSNs), such as housing and nutrition. 

CMS is working with State Medicaid Agencies in eight states to engage in full care transformation across payers, with plans to engage private payers in the coming months. 

The CMS MCP Model will provide a pathway for primary care clinicians with varying levels of experience in value-based care to gradually adopt prospective, population-based payments while building infrastructure to improve behavioral health and specialty integration and drive equitable access to care.

Practices will undergo a significant transition toward value-based care. This model emphasizes comprehensive patient-centered care requiring facilities to closely monitor and improve outcomes, manage financial resources and adapt to new performance metrics. Practices must conduct advanced MCP data analytics and implement health IT systems to better understand their patient populations and track care outcomes.

Practices will need to continuously improve quality and work with various healthcare professionals to meet their patients’ complex needs. With these changes, there is an aim to enhance care coordination, reduce healthcare costs and ultimately deliver higher-quality care to their communities. By leveraging DataGen's consulting and guidance, practices can optimize their performance and achieve success in the value-based care model.

Let’s explore how practices can overcome limitations in the evolving healthcare landscape.

Overcoming Limitations 

MCP is complex; however, a lack of resources, staff or knowledge should not hinder practice growth and success. It introduces a gradual shift from traditional fee-for-service payment to full capitation for certain primary care services, aligning care delivery with advanced, scheduled payment. To navigate the complexities of the MCP model, it is essential to have access to the right tools and expert guidance.

CMS underscores the importance of promoting data and health information exchange (HIE) to enhance care coordination with specialists. Care teams will need to have adequate knowledge and resources to foster a dynamic environment, drive continuous improvement and deliver exceptional patient care. 

Exceptional Analytics for MCP Success

Participating in value-based care demands a deep understanding of the patient population across the continuum of care. Tailored analytics provide the insights needed to make informed decisions and optimize performance.

Look into solutions with the following components:

  • Understand Financial Drivers: Gain insights into the financial aspects of MCP participation, such as total cost of care. Specifically, identify opportunities for cost savings and revenue enhancement.

  • Monitor Utilization: Track and analyze the utilization of healthcare services by patient characteristics and claim setting to understand Medicare cost drivers and strategize efficient care transitions.

  • Evaluate Health Outcomes: Assess the impact of care interventions on patient health outcomes, identify areas for improvement, enhance patient satisfaction and implement advanced primary care.

With DataGen's customized analytics, discover the metrics that drive meaningful change.

Why DataGen: Boutique MCP Analytics and Consulting 

Navigating the complexities of MCP and value-based care requires a strategic approach and the right set of tools and resources. DataGen offers a comprehensive suite of analytics, reporting and consulting services designed to empower your practice and position you for success in today's competitive healthcare landscape.

By using DataGen’s MCP solution, you can overcome limitations, unlock valuable insights and cultivate a culture of excellence that drives continuous improvement and delivers exceptional patient care. Our tailored solutions address the unique challenges of MCP, ensuring you stay ahead in a rapidly evolving field. DataGen supports practices by offering ongoing assistance and personalized education to help overcome obstacles with innovative solutions for MCP success.

Contact us today to learn more about how DataGen can help your practice unlock value-based care’s full potential in the era of value-based care. Read our Making Care Primary: The Ultimate 3-Track Guide for more details on the model and its design.

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