Multi-payer Advanced Primary Care Practice Demonstration (MAPCP) an Important and Challenging Opportunity for States

On June 2, HHS and CMS announced that states were invited to apply to participate in a Multi-payer Advanced Primary Care Practice Demonstration (MAPCPD).  This demonstration represents a marked evolution and maturation in how CMS is thinking about transforming primary care to be more effective in improving health outcomes and controlling costs. 

This demonstration establishes many important new and very challenging requirements for States (link to CMS demo info).  HQP has considerable strength and proven effectiveness in addressing several of these challenges.  Including;

• Establishing multi-disciplinary teams that include community health resources.
• Integrating medical services with community resources, including community-based health promotion and disease prevention initiatives.
• On-going quality and performance measurement.
• Coordinating transitions across care settings.
• Supporting self-management by patients.
• Achieving budget neutrality.
• Initiative monitoring and evaluation.

These are daunting tasks that HQP could help a State successfully address.   We gained great experience from the Medicare Coordinated Care Demonstration randomizing over 2,500 participants in a 4-county area of eastern Pennsylvania from more than 120 primary care physician offices, the scope of our work is comparable to what State’s can propose as a regional pilot in the initial stages of this demonstration. Our experience in implementing the HQP Community-based nurse care management model on behalf of both fee-for-service Medicare beneficiaries and Aetna Medicare Advantage members gives us an appreciation for implementing an effective community-based model across different payers in the same primary care offices.

It is not easy to figure out how to reliably execute on a population-based model that can transform a modest PPPM (per person per month) revenue stream into effective interventions targeted to the right subgroups of patients to achieve savings that offsets the full cost of the program and improve health outcomes.  HQP has the experience, the means, and the commitment to mission needed to help State’s achieve these ambitious aims.