High-quality primary care is a critical tool to advance health equity within Medicaid. To support higher-quality, more equitable primary care, there is growing consensus that payment reform is necessary. Medicaid primary care population-based payment (PBP) models — advanced value-based payment (VBP) approaches that pay provider organizations through upfront, flexible payments tied to quality incentives — offer a key means to improve primary care.
By moving further away from a fee-for-service architecture than other VBP models, primary care PBP allows providers the freedom to implement health equity-focused strategies that are not typically paid for under fee-for-service. Yet, the promise of primary care PBP models to advance health equity in Medicaid will not be fully realized unless such models include explicit health equity incentives and adequate investment in primary care to support improvements in care delivery.
In this Health Affairs blog post, authors from the Center for Health Care Strategies explore considerations for state policymakers implementing Medicaid primary care PBP models to ensure that provider organizations have the right financial incentives to work toward more equitable care delivery and significantly reduce health disparities.