Primary care is the essential backbone of any health care system, particularly for low-income and Medicaid populations, which may be more likely to face barriers to care. In response, states are seeking to accelerate the adoption of advanced primary care models that emphasize team-based care, leverage telehealth, and address behavioral health and social needs. With 39 states using risk-based managed care, the majority of state Medicaid agencies are well-positioned to use their purchasing levers to drive more widespread adoption of these models.
This webinar, made by possible by The Commonwealth Fund, described state opportunities for advancing innovation in primary care, drawing on lessons from the Center for Health Care Strategies’ (CHCS) Advancing Primary Care Innovation in Medicaid Managed Care (PCI) initiative. It highlighted considerations for: (1) identifying priorities; (2) designing managed care strategies; and (3) advancing targeted care delivery goals identified in a recently published toolkit. The webinar also featured lessons from Hawaii’s participation in the first phase of the PCI learning collaborative; related work led by George Washington University; and an opportunity for states to participate in a second phase of the initiative.
I. Welcome and Introductions
Speakers: Rachael Matulis, Senior Program Officer, CHCS; Laurie Zephyrin, Vice President, Delivery System Reform, The Commonwealth Fund
R. Matulis welcomed participants and provided an overview of the goals and structure of the PCI initiative. Laurie Zephyrin described how the PCI initiative fits within The Commonwealth Fund’s broader portfolio of efforts focused on innovation in primary care.
II. Early Lessons on Advancing Primary Care Innovation in Medicaid Managed Care
Speaker: Diana Crumley, Senior Program Officer, CHCS
D. Crumley presented approaches and lessons from PCI Phase I related to how states can identify primary care priorities and design strategies to advance innovation. Diana also introduced CHCS’ Advancing Primary Care Innovation in Medicaid Managed Care Toolkit.
III. Hawaii’s Approach to Advancing Primary Care Innovation
Speakers: Joy Soares, Policy Analyst, Hawaii Medicaid
J. Soares described Hawaii’s approach to primary care innovation and the impact of the PCI initiative, including examples of Hawaii’s primary care innovation goals, primary care-related initiatives, and MCO contracting strategies.
IV. Introducing Phase II of Advancing Primary Care Innovation in Medicaid Managed Care
Speaker: Rachael Matulis, Senior Program Officer, CHCS
CHCS provided an overview of the structure of PCI Phase II and described how states can apply.
III. George Washington University’s Managed Care Contracting & Primary Care Innovation Tools
Speakers: Sara Rosenbaum, Harold and Jane Hirsh Professor of Health Law and Policy and Founding Chair of the Department of Health Policy, Milken Institute School of Public Health, George Washington University
S. Rosenbaum provided an overview of her team’s research into primary care innovation through Medicaid managed care and how they are developing a managed care contract language database. She described how this work aligns with the PCI initiative and how her work was used to support states in PCI Phase I.
V. Moderated Q&A
Moderator: Rachael Matulis, Senior Program Officer, CHCS