The Health Care Authority (HCA) is seeking comments on its proposed Multi-payer Primary Care Transformation Model. The model was developed during the last year in collaboration with workgroups including Washington state health care plans and primary care providers. Comments must be submitted to HCA by Friday, July 31, 2020. WSHA is also planning to comment on the model. If you are a WSHA member that provides primary care and would like your input included in our comments, please contact Andrew Busz at andrewb@wsha.org no later than Tuesday, July 28.
HCA designed the new model to strengthen primary care through multi-payer payment reform and care delivery transformation. HCA is attempting to promote access to integrated, whole person and team-based care and align payment incentives and quality metrics across payors and providers. Under the model, payers would commit to increase their primary care spending as a proportion of care in order to eventually reduce total health care costs. The payment model includes three components:
- Transformation of Care Fee, limited duration funding to aid transformation to the new model;
- Comprehensive Primary Care Payment, a fixed per member per month payment to cover integrated primary care; and
- Performance Incentive Payment based on attainment of utilization and quality thresholds.
More information on the model is available on HCA’s Multi-payer Primary Care Transformation Model page. (Andrew Busz, andrewb@wsha.org).
