Making care primary: a renewed investment into primary care

The Making Care Primary (MCP) model represents a sharp shift in Medicare’s approach to primary care, yet its current design risks duplicating failures from prior alternative payment models. Our editorial suggests refinements to address these gaps. To prevent early provider dropout from MCP’s rigid t...

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Main Authors: Cameron J. Sabet, Bhav Jain, Sandeep Palakodeti
Format: Article
Language:English
Published: Cambridge University Press
Series:Health Economics, Policy and Law
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S174413312510011X/type/journal_article
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author Cameron J. Sabet
Bhav Jain
Sandeep Palakodeti
author_facet Cameron J. Sabet
Bhav Jain
Sandeep Palakodeti
author_sort Cameron J. Sabet
collection DOAJ
description The Making Care Primary (MCP) model represents a sharp shift in Medicare’s approach to primary care, yet its current design risks duplicating failures from prior alternative payment models. Our editorial suggests refinements to address these gaps. To prevent early provider dropout from MCP’s rigid track-based system, we propose a sliding-scale infrastructure payment model that adjusts based on practice needs rather than abrupt phase-outs. Given MCP’s reliance on community-based organisations (CBOs) for social determinants of health interventions, we also advocate for direct, outcomes-based contracts between providers and CBOs, ensuring accountability for patient outcomes rather than passive referrals. We recommend that MCP enforce data-sharing mandates for commercial insurers and Medicaid agencies, drawing from Washington State’s successful Multi-Payer Collaborative, to avoid payer disengagement that plagued previous multi-payer models. To expand beyond conventional quality measures, we propose integrating patient-centred outcomes from the International Consortium for Health Outcomes Measurement, making sure MCP captures meaningful clinical impact. Finally, we propose programme adjustments frequently at two- to three-year intervals to refine risk adjustment methodologies. These approaches could enhance MCP’s sustainability, preventing the financial instability and misaligned incentives that undermined past value-based care initiatives.
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spelling doaj-art-ea17824c623a4e93b3d9272c60323abb2025-08-20T03:11:55ZengCambridge University PressHealth Economics, Policy and Law1744-13311744-134X11110.1017/S174413312510011XMaking care primary: a renewed investment into primary careCameron J. Sabet0https://orcid.org/0000-0003-2299-1426Bhav Jain1Sandeep Palakodeti2Georgetown University School of Medicine, Washington, DC, USAStanford University School of Medicine, Stanford, CA, USAMishe Health, New York, NY, USAThe Making Care Primary (MCP) model represents a sharp shift in Medicare’s approach to primary care, yet its current design risks duplicating failures from prior alternative payment models. Our editorial suggests refinements to address these gaps. To prevent early provider dropout from MCP’s rigid track-based system, we propose a sliding-scale infrastructure payment model that adjusts based on practice needs rather than abrupt phase-outs. Given MCP’s reliance on community-based organisations (CBOs) for social determinants of health interventions, we also advocate for direct, outcomes-based contracts between providers and CBOs, ensuring accountability for patient outcomes rather than passive referrals. We recommend that MCP enforce data-sharing mandates for commercial insurers and Medicaid agencies, drawing from Washington State’s successful Multi-Payer Collaborative, to avoid payer disengagement that plagued previous multi-payer models. To expand beyond conventional quality measures, we propose integrating patient-centred outcomes from the International Consortium for Health Outcomes Measurement, making sure MCP captures meaningful clinical impact. Finally, we propose programme adjustments frequently at two- to three-year intervals to refine risk adjustment methodologies. These approaches could enhance MCP’s sustainability, preventing the financial instability and misaligned incentives that undermined past value-based care initiatives.https://www.cambridge.org/core/product/identifier/S174413312510011X/type/journal_articleeconomicspolicyhealth disparities
spellingShingle Cameron J. Sabet
Bhav Jain
Sandeep Palakodeti
Making care primary: a renewed investment into primary care
Health Economics, Policy and Law
economics
policy
health disparities
title Making care primary: a renewed investment into primary care
title_full Making care primary: a renewed investment into primary care
title_fullStr Making care primary: a renewed investment into primary care
title_full_unstemmed Making care primary: a renewed investment into primary care
title_short Making care primary: a renewed investment into primary care
title_sort making care primary a renewed investment into primary care
topic economics
policy
health disparities
url https://www.cambridge.org/core/product/identifier/S174413312510011X/type/journal_article
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AT bhavjain makingcareprimaryarenewedinvestmentintoprimarycare
AT sandeeppalakodeti makingcareprimaryarenewedinvestmentintoprimarycare