Primary Care Transformation

Multi-Payer Collaborative overview

The Washington Multi-Payer Collaborative (MPC) is a group of payers working to build collective approaches to supporting patients and providers that will yield greater results than independent action, with a focus on the transformation of primary care delivery and payment.

The current MPC focus is primary care, recognizing:

• The importance of primary care in improving outcomes, and
• The opportunity to improve access to high-quality comprehensive primary care.

Primary Care Transformation Initiative

The Primary Care Transformation Initiative (PCTI) is Washington’s comprehensive strategy to strengthen and support primary care through aligned payment methodologies, increased investment, and care delivery transformation. HCA co-designed the strategy with Washington health care providers, insurance plans, employers, health insurance purchasers, subject-matter experts, and other partners.

The goal of these transformation efforts is to achieve the quadruple aim of enhancing patient experience, improving population health, reducing costs, and improving the work life of health care providers. The PCTI includes the Multi-payer Collaborative Primary Care Transformation Model and the federal program Making Care Primary.

Multi-payer Collaborative Primary Care Transformation Model

The Primary Care Transformation Model (PCTM) is a set of strategies developed by Washington health care providers, insurance plans, and purchasers to strengthen primary care in Washington. It includes aligned payment methodologies, increased investment, and care delivery transformation tailored to the needs of Washington residents.

The PCTM also includes HCA’s Primary Care Practice Recognition (PCPR) program. The PCPR is a process to evaluate provider capabilities. Based on this evaluation, providers are assigned a level rating from 1 to 3. View the PCPR accountabilities guide.

Making Care Primary

Making Care Primary (MCP), is a 10.5-year, valued-based care model for Medicare beneficiaries from the Centers for Medicare & Medicaid Services (CMS). Washington was selected as one of 8 states participating in the model with the goals of achieving multi-payer alignment, improving health equity outcomes, and more.

HCA intends to align and partner with CMS to accelerate change and achieve shared goals of implementing a more comprehensive and long-lasting primary care model for Washington residents.

Multi-Payer Collaborative learning cohort

The MPC’s first learning cohort of primary care practice representatives will work with the payers to identify collaborative, aligned strategies to support the delivery of coordinated, team-based care through the PCTI.

The learning cohort is an avenue for providers to shape where payers align their efforts to create primary care provider supports. Participating practices will also share advice and lessons learned with other practices and plans engaged in the PCTM and/or the federal Making Care Primary model.

News

Resources

• Signed Multi-Payer Collaborative memorandum of understanding (2024)
• Primary Care Transformation Initiative memorandum of understanding (2024)
• Signed Multi-payer Primary Care Transformation Model memorandum of understanding (MOU) (2020)
• Purchaser Primary Care Transformation support letter (January 26, 2021)
• Multi-payer Primary Care Transformation Model description (January 27, 2022)