Start: May 2018

Funder: The Commonwealth Fund

Primary care is the essential backbone of any health care system, particularly for low-income populations. Across the United States, a variety of advanced primary care models — including patient-centered medical homes, Medicaid accountable care organizations, and Comprehensive Primary Care Plus programs among others — are offering new ways to enhance primary care delivery. Despite the growth of these models, however, low-income individuals have consistently low rates of primary care utilization as well as poor health outcomes. With more than 80 percent of the nation’s Medicaid beneficiaries enrolled in managed care, strengthening primary care delivery through managed care levers offers one option to improve access, quality and efficiency of health care services for society’s most vulnerable patients.

Under Advancing Primary Care Innovation in Medicaid Managed Care, made possible by The Commonwealth Fund, the Center for Health Care Strategies (CHCS) is working with five state Medicaid agencies — in Hawaii, Louisiana, Pennsylvania, Rhode Island, and Washington — that are supporting high-performing primary care systems for vulnerable populations through their Medicaid managed care programs. The project is focusing on using states’ managed care purchasing authority to advance primary care models that aim to address one or more of the following four care delivery components:

  • Addressing social determinants of health;
  • Integrating behavioral health into primary care;
  • Using technology to improve access to care; and
  • Enhancing team-based primary care approaches that better meet the community’s needs.

Over 12 months, participating states will seek to design, implement, and scale innovative approaches to primary care delivery. Participants will receive tailored one-on-one technical assistance as well as peer-to-peer information sharing, convening, and learning opportunities. Lessons from the participating states will be synthesized and shared nationally to help additional states maximize the potential of managed care for strengthening primary care delivery.