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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 (PCTM) will be a framework that aims to strengthen primary care through multi-payer payment reform and care delivery transformation.

Spring 2022 primary care provider survey

For the Primary Care Transformation Model to work, we need to understand your clinic’s/practice’s current capacities and needs to implement the envisioned model. Your perspective is critical as we work to design a sustainable primary care model for patients, providers, payers, and purchasers.

Additionally, this survey seeks to find provider groups that are already providing whole person care as outlined in the model.

Our ask

Please do not disregard or delay. Use this as the opportunity to familiarize yourself and your colleagues with the developing model by reviewing the current model description and providing your feedback through this survey. You can download a copy of the survey questions for reference before and while completing the survey.

We expect this should take about 20-25 minutes. The survey is designed for completion by an administrative leader, with consultation where necessary from clinicians. Please provide a single organization-level survey response by June 6.

The survey asks questions on your clinic’s/practice’s:

  • Current contracting relationships with commercial, Medicare, Medicaid, and other payers
  • Capacity to deliver integrated, whole person and team-based care as outlined in the current version of the model’s provider accountabilities
  • The required resources needed for your organization to advance in meeting the accountabilities

Take the PCTM provider survey

News

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.

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.

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.

Resources

 

[1] Primary Care Development Corporation

Contact

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