Q&A: Considerations for joining CMS' Primary Care First Model

Q: CMS' Primary Care First Model Options program begins in 2021, but what should our facility be considering now if we want to join?

A: Since these models of care are patient-focused and outcome-driven, it will be important to develop a capability to engage patients and families to adopt healthy behaviors. Provider practices will need to ramp up their PR, marketing, and communication skills as they seek to influence patient behaviors. A collaborative, multidisciplinary approach will be most effective, as wise clinicians realize that leading a diverse team of clinical and operational professionals will be vastly more effective than adopting the traditional, paternalistic paradigm. Two principles are key here: It takes a team approach to be successful, and the bottom-line focus is on improving health outcomes, instead of delivering services.

Thriving under these new payment models will require a performance-oriented, information-driven practice. Those of us who have long supported focusing on primary care, outcomes, care coordination, chronic disease management, and patient engagement will have increased opportunities to see if all this will really work. For all its criticism, the Affordable Care Act has created structures and incentives to finally align our healthcare system to make people healthier, instead of just delivering services.

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