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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.[1]

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.

About the model

The purpose of the Multi-payer Primary Care Transformation Model (PCTM) is to create better health and better care for patients, smarter spending, and improved clinical experience for providers.

Goals of the model

The overarching goal of Washington’s health care transformation efforts is to achieve the quadruple aim of enhancing patient experience, improving population health (i.e., health outcomes), reducing costs, and improving the work life of health care providers, including clinicians and staff. 

  • Promote and incentivize integrated, whole-person and team-based care. This includes primary physical and behavioral health care services for acute, chronic, and preventive needs.
  • Improve primary care provider capacity and access.
  • Increase investment in a transformed primary care system while better managing total cost of care over time. 
  • Align payment incentives as well as quality metrics across payers and providers.
  • Work with interested public and private employers to spread and scale the model throughout Washington State.

Work groups

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.

News

Resources

 

[1] Primary Care Development Corporation

Contact

Primary Care Transformation
Email:
HCAPCTM@hca.wa.gov