Primary Care Providers (PCPs) are at the heart of healthcare, ensuring comprehensive, coordinated, and continuous care for patients. In the evolving landscape of value-based care, several programs beckon PCPs, with Making Care Primary (MCP) and the Medicare Shared Savings Program (MSSP) being prominent contenders. While both have their merits, MCP distinctly stands out for its upside-only financial structure, tailored flexibility for all experience levels, emphasis on individual performance, and a rich toolkit for success. These features collectively make MCP a more advantageous choice for PCPs, offering them a conducive environment to innovate and enhance patient care without undue financial pressures or constraints.
Financial risks can be daunting, especially when they come with potential losses. MCP's "upside-only" risk structure is a breath of fresh air in this context. It promises providers a share in the savings they generate without the sword of shared losses hanging over their heads. This model encourages innovation and quality care enhancement, as providers can experiment without the fear of financial backlash. MCP distinctly stands out for its ability for a provider to advance from FFS to VBC without taking on any downside risk. This applies to all 3 participation tracks and experience levels, whereas MSSP only offers this for its most basic participation track. While many providers choose to join this track in MSSP, this can act as a deterrent for those who want to pursue track 2 or 3 but aren’t comfortable with the associated downside risk. For a deeper dive into the financial aspects of value-based care, check out our article on How to Use Analytics for Decision-Making in Value-Based Care.
In a world that often emphasizes collective performance, MCP's focus on individual performance is a refreshing change. Your efforts, innovations, and successes are recognized and rewarded, independent of how other providers perform. This ensures that high-performers aren't penalized for the shortcomings of others. MSSP, in contrast, often pools results with the participants being a part of a larger ACO organization. This means that even if you're a top performer, the average performance can be pulled down by others, potentially affecting your compensation at the end of a measurement year. Imagine being part of an ACO where another provider's decisions, driven by their unique circumstances, could impact your performance metrics and, ultimately, your financial returns. What if a fellow provider in your ACO is nearing retirement or has mounting financial debts and adopts a more conservative approach to patient care, or is more aggressive in patient treatment because they're looking to sell the practice? Their decisions could skew the collective performance data, affecting your share of any potential savings.
In today's digital age, the right tools can make all the difference. MCP understands this and offers an extensive toolkit to its participants1. From advanced health IT systems to service navigation tools, MCP ensures providers have what they need. A standout feature is MCP's direct equipping of primary care organizations with tools to enhance care coordination with top-tier specialists. This includes access to data dashboards, collaborative care arrangements, model-specific interprofessional consultation, and time-limited co-management billing privileges. While MSSP does provide tools, MCP's offerings are more holistic, ensuring a seamless integration into daily operations. Beyond this, for track 1 participants can qualify for Upfront Infrastructure Payments (UIP), which consists of 2 annual payments of $72,500. This “use it or lose it” payment allows practices to build the infrastructure that help enhance patient care and outcomes. This includes areas such as additional staffing, implementation of SDOH strategies, or HCIT infrastructure tools such as Diagnostic Robotics.
Change, especially in healthcare, takes time. Having learned from MSSP that investments in implementing VBC infrastructure require years to yield their full benefit, CMS has committed to run the MCP program for 10.5 years. MCP’s extended duration offers providers a stable and conducive environment, allowing ample time for thoughtful implementation, continuous refinement, and sustained efforts towards enhancing care quality and patient outcomes. This commitment in MCP not only alleviates the pressures associated with rapid transitions but also fosters a sense of reliability and assurance, making it a more attractive option for providers seeking a seamless and rewarding journey in value-based care.
In conclusion, MCP stands out as the superior choice for PCPs for several compelling reasons. Its upside-only financial structure removes the burden of potential losses, allowing providers to innovate without financial fears. The program's flexibility ensures that both experienced providers and newcomers find a conducive environment tailored to their needs. With a focus on individual performance, MCP ensures that high-performers are recognized and rewarded without being overshadowed by the collective. The comprehensive toolkit provided by MCP ensures providers are well-equipped to tackle modern healthcare challenges. Lastly, the extended 10.5-year commitment of MCP offers stability and continuity, allowing providers ample time to implement, refine, and see the fruits of their strategies. While MSSP has its merits, when it comes to offering a holistic, supportive, and long-term environment for primary care transformation, MCP clearly takes the lead. Of note: organizations currently participating in the Medicare Shared Savings Program can use a one-time exception to withdraw before January 1, 2025 in order to join MCP.
Interested in how our solutions can empower your practice? Explore Diagnostic Robotics' solution for providers that want to join Medicare's Making Care Primary Program and see how we're shaping the future of healthcare.
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