New CMMI Primary Care Demo Could Pave Way for Hospice, Palliative Partnerships

A new primary care-focused payment model demonstration could create new partnership opportunities for hospice and palliative care providers.

The U.S. Centers for Medicare & Medicaid Services (CMS) has unveiled the Making Care Primary (MC) model, which will launch in July 2024 in eight states — Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington.

The agency intends for the 10-year demo to expand and enhance care management and care coordination. CMS plans to equip participating primary care clinicians with tools to form partnerships with specialists and to leverage community-based connections to address patients’ health and social needs.

This could include partnerships with hospice and palliative care clinicians.

“Palliative and hospice care are critical to a patient’s care journey. MCP participants will be required to form partnerships with clinicians of various specialty types, which will be referred to as Specialty Care Partners,” a CMS spokesperson told Hospice News in an email. “The final list of allowable specialty types for Specialty Care Partners will be released in the Request for Applications, but we anticipate that it will include hospice/palliative care.”

The program has three goals, according to CMS:

1) Ensure patients receive primary care that is integrated, coordinated, person-centered and accountable.

2) Create a pathway for primary care organizations and practices – especially small, independent, rural, and safety net organizations – to enter into value-based care arrangements.

3) Improve the quality of care and health outcomes of patients while reducing program expenditures.

Participating providers will be divided into three tracks based on their degree of experience with value-based care and alternative payment models. Home-based primary care providers are eligible to participate if they meet the program’s eligibility criteria, CMS confirmed to Hospice News.

Primary care operators that participate in the program will receive additional revenue to build infrastructure, make primary care services more accessible and improve coordination with specialists, CMS indicated.

The program will build upon previous primary care models, such as the Comprehensive Primary Care (CPC), CPC+, Primary Care First models, and the Maryland Primary Care Program (MDPCP), according to the agency.

“The goal of the Making Care Primary Model is to improve care for people with Medicaid and Medicare,” said CMS Administrator Chiquita Brooks-LaSure, in a statement. “This model is one more pathway CMS is taking to improve access to care and quality of care, especially to those in rural areas and other underserved populations. This model focuses on improving care management and care coordination, equipping primary care clinicians with tools to form partnerships with health care specialists, and partnering with community-based organizations, which will help the people we serve with better managing their health conditions and reaching their health goals.”