The Centers for Medicare & Medicaid Services (CMS) Making Care Primary (MCP) model, a voluntary program launching in eight states on July 1, 2024, transforms primary care delivery by emphasizing access to high-quality, comprehensive primary care services. It does this by promoting care coordination, patient engagement, and population health management, with the ultimate aim of improving health outcomes, reducing healthcare costs, and enhancing the overall patient experience within the primary care setting.
By incentivizing proactive and preventive healthcare measures and shifting the focus from fee-for-service to value-based care, the MCP model encourages primary care providers in those certain states to adopt innovative approaches, such as team-based care, telehealth services, and proactive chronic disease management.
Though the MCP model is not yet available in all states, it is a positive initiative that providers in other states can still learn from. Here are just some of the ways MCP encourages primary care providers to improve quality of care and reduce healthcare costs, which you can implement as well, with help from WellSky solutions:
Streamlining care delivery
Care coordination plays a pivotal role in the MCP model by fostering seamless collaboration among healthcare providers and ensuring patients receive comprehensive, efficient, and high-quality care. This can help enhance care continuity, reduce unnecessary healthcare utilization, and minimize fragmented care delivery. Additionally, it enables timely access to necessary services, promotes preventive care initiatives, and empowers patients to actively participate in their own healthcare decisions, ultimately improving health outcomes and enhancing the overall patient experience.
With WellSky software solutions, primary care providers gain the ability to communicate electronically with other providers about their patients. They can send in-solution messages for quick updates, share high-quality provider options with acute discharge planners, and connect to the most complete care coordination network. Real-time clinical data, access to acute referral information, and a customizable 360-view of their patient panel gives providers the ability to track and manage patients across the care continuum, all thanks to WellSky.
Putting patients first
Equitable care is crucial for Medicare and Medicaid beneficiaries, and is, therefore, critical to success in MCP. By focusing on strategies such as addressing social determinants of health, providing culturally competent care, and collecting and analyzing data, providers can help narrow gaps in healthcare access, improving health outcomes and advancing health equity for all patients — especially those from marginalized and underserved populations.
An important focus of the MCP model is on patients with complex medical needs and serious illnesses. These patients often require additional care, coordination, and support to manage their conditions effectively. By providing enhanced resources and tailored interventions to them, providers can improve care and outcomes for these seriously ill patients while reducing unnecessary hospitalizations and emergency department (ED) visits.
With WellSky solutions, providers gain visibility into vital factors like readmission risk, utilization history, and participation in value-based care programs, which helps them more efficiently address gaps in care and intervene when patients with complex needs transition through the continuum of care. As a value-based patient presents to the ED, care coordinators have the unique opportunity to engage with ED staff before the patient is even admitted. WellSky solutions give providers the ability to identify trends in care utilization, opportunities for targeted interventions, and the socioeconomic needs of their patients. This real-time data, coupled with the intelligence, helps reduce readmissions — an important metric for success in the MCP model.
Enhancing quality of care
Metrics on post-acute provider performance, utilization, and health outcomes are crucial for physician practices and can help guide informed decision-making and enhance patient care. Monitoring patient outcomes helps identify areas for improvement and tailoring treatments, while tracking utilization rates optimizes resource allocation. Additionally, analyzing cost efficiencies identifies opportunities for savings without compromising care quality. By leveraging this data, practices can continuously improve outcomes and deliver the highest standard of care to patients.
Sending patients to high-performing post-acute providers is vital to value-based care success and patient outcomes. WellSky analyzes post-acute provider performance, helping you build and manage your post-acute care collaboration, ensuring your patients receive the best care possible. With WellSky, providers can make more informed decisions to improve outcomes and control the total cost of care.
Improving the patient experience
By focusing on enhancing the overall experience for patients, the MCP model aims to strengthen the patient-provider relationship, increase patient satisfaction, and ultimately improve health outcomes. Two important goals of this model are:
- To increase access to more community-based and specialized care and services
- To encourage patients to actively participate in their own care decisions to foster better trust and communication between patients and providers
With WellSky, providers can extend their reach beyond the four walls of their practice and engage patients at the right time, with the right care.
The MCP model represents a shift in healthcare delivery — one that prioritizes patient-centered care, quality improvement, and financial sustainability. But even if you are not in a state currently using the MCP model, by leveraging WellSky solutions, primary care providers can still gain visibility into where their patients are receiving care, the intelligence to prioritize the right patient at the right time with the right resources, and the opportunity to influence care plans.
Learn more about how WellSky supports providers drive better outcomes for patients.
