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Multi-payer Primary Care Transformation Model
Primary care is the foundation of our health care system. Evidence shows greater use of primary care is associated with lower costs, higher patient satisfaction, fewer hospitalizations and emergency department visits, and lower mortality.
The Multi-payer Primary Care Transformation Model will be a framework that aims to strengthen primary care through multi-payer payment reform and care delivery transformation.
The purpose of this model is to create better health and better care for patients, smarter spending, and improved clinical experience for providers. You can read more about it in HCA's Multi-payer Primary Care Transformation Model briefing paper.
- Increase primary care expenditures while decreasing total health spending.
- Align payment and incentives across payers as well as quality metrics across both payers and providers.
- Promote and incentivize integrated, whole-person and team-based care. This includes primary care, physical and behavioral health care, and preventive services.
- Improve provider capacity and access.
- Work with interested public and private employers to spread and scale the model throughout Washington State.
We have been working with Washington State health care plans and primary care providers on developing this model during this last year. Two work groups were formed in May 2019 to refine the model elements. One work group helped refine the payment component of the model. The other work group helped refine the proposed quality metrics.
Through 2020, we will continue working with work group members, partners, and others to implement the Multi-payer Primary Care Transformation Model. View the roster of our work group members.
Health Care Authority (HCA) is holding a public comment period on the proposed Multi-payer Primary Care Transformation Model. If you would like to participate, please complete our survey. Note: we encourage you to read about the proposed model before providing public comment.
The public comment period ends Friday, July 31, 2020. This will be an opportunity for payers (health care plans), providers, and many others to share their input. Feedback received will help HCA and our partners to further develop this model, and improve the health and health care delivery for Washington residents.
|July 31, 2020||Public comment for HCA’s proposed primary care model extended to August 7|
|July 27, 2020||Reminder: public comment for HCA's proposed primary care model ends July 31|
July 10, 2020
- Results of Multi-payer Primary Care Transformation Model survey (May 2020)
- Primary Care Expenditure Template (contract requirement in calendar year 2020 Medicaid MCOs contracts)
- Primary Care Expenditure Template (contract requirement in most calendar year 2020 public and school employee contracts)