New model aims to enhance access and quality of primary care, improve health system
FOR IMMEDIATE RELEASE
June 21, 2023
Department of Health Care Policy & Financing
Division of Insurance
Denver, CO - Recently, the Centers for Medicare & Medicaid Services (CMS) announced that it will be partnering with Colorado to pilot a new primary care model to enhance access to and quality of primary care services. Access to high-quality primary care is associated with better health outcomes and equity for people and communities. Colorado’s collaboration with CMS on the Making Care Primary (MCP) Model will boost Colorado’s current efforts to strengthen the state’s primary care infrastructure, especially for safety-net and smaller or independent primary care organizations.
Strong relationships with primary care teams are essential for patients’ overall health. Primary care clinicians provide preventive services, help manage chronic conditions, and coordinate care with other clinicians. By investing in behavioral and medical care integration and patient care support capabilities, primary care teams will be better equipped to address chronic disease, improve the health of Coloradans, and lessen the likelihood of avoidable emergency department visits and hospital care stays. This ultimately improves patient satisfaction and patient health, while saving Coloradans and our employers money on health care. This model will also help improve health equity and reduce health disparities across Colorado.
“Money talks. We want to financially reward primary care doctors who improve care quality, help their patients better manage their health, and save Coloradans money on health care. That’s what this alternative payment methodology - or value based payment - does,” said Kim Bimestefer, executive director for the Department of Health Care Policy & Financing. “These more advanced payment methodologies also reward PCPs for reducing health disparities, which is a priority goal for our state.”
"Alternative Payment Models are a vital piece of the Division's work in improving health care quality, access and affordability for all Coloradans," said Colorado Insurance Commissioner Michael Conway. "Partnering with CMS on the Making Care Primary Model will improve the ability to measure health care quality, improve access to care and build on past successes to bring even more affordability to consumers."
Colorado is one of several states, including Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington, where CMS will be testing this advanced primary care model. The model’s flexible multi-payer alignment strategy allows CMS to build on existing state innovations and for all patients served by participating primary care clinicians to benefit from improvements in care delivery, financial investments in primary care, and learning tools and supports.
Colorado has a strong history of multi-payer alignment, and our partnership with CMS has played an important role in that work. Many payers, including Health First Colorado (Colorado’s Medicaid Program) are shifting towards value-based care. MCP will build off of the current APM 2 payment model with the Department of Health Care Policy & Financing and align with the Division of Insurance, as Colorado implements HB22-1325, Primary Care Alternative Payment Models. Aligning payment models across markets, including Medicare, Medicaid, and commercial insurance, is a crucial step in improving health care quality, access, and outcomes for all Coloradoans.
Primary care organizations in Colorado that are interested in participating can find more information about the MCP model and applications, which will open later this summer, on the MCP web page.
About the Colorado Department of Health Care Policy & Financing: The Department administers Health First Colorado (Colorado's Medicaid program), Child Health Plan Plus, and other programs for Coloradans who qualify. These health care programs now cover about one in four Coloradans. For more information about the Department, please visit hcpf.colorado.gov.
About the Colorado Division of Insurance: The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), regulates the insurance industry and assists consumers and other stakeholders with insurance issues. Visit doi.colorado.gov for more information or call 303-894-7499 / toll free 800-930-3745.