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As Medicaid programs across the country seek to strengthen primary care, many states are considering primary care population-based payment (PBP) models. These models provide upfront payment to primary care practices, creating budget stability for states and practices, along with flexibility for primary care teams to deliver person-centered and equitable care. To design effective primary care PBP models, states need to make key decisions regarding patient and provider inclusion, service scope, payment structure, patient attribution, rate setting, and care delivery changes. Lessons from existing primary care models, new primary care PBP approaches, and models currently in design can help states considering or beginning to design a primary care PBP model.

This webinar, made possible by Arnold Ventures and The Commonwealth Fund, explored how states can design and refine PBP models in Medicaid to strengthen primary care. The webinar explored key design choices states need to make when developing these models. It featured a panel discussion with Medicaid agency staff from three states — Colorado, Connecticut, and Massachusetts — that are pursuing primary care PBP models.


I. Welcome and Introductions

Speaker: Rob Houston, MBA, MPP, Director of Delivery System and Payment Reform, Center for Health Care Strategies (CHCS)

R. Houston welcomed webinar participants and provided opening remarks about the value of primary care PBP models.

II. Developing Primary Care PBP Models in Medicaid

Speaker: Anne Smithey, MPH, Program Officer, CHCS

A. Smithey provided an overview of CHCS’ recently released Developing Primary Care Population-Based Payment Models in Medicaid: A Primer for States. She explored key design choices that states need to make when developing effective primary care PBP models and shared examples and implications of these choices.

III. Panel: Designing Primary Care Models in Colorado, Connecticut, and Massachusetts


  • Araceli Santistevan, MPPA, APM 2 Payment Reform Analyst, Colorado Department of Health Care Policy & Financing;
  • Brad Richards, MD, MBA, Outgoing Chief Medical Officer, Connecticut Department of Social Services; and
  • Sabrina Werts, MPH, Senior Manager of Primary Care Strategy, MassHealth

A. Smithey facilitated a panel highlighting approaches to primary care PBP in three state Medicaid programs: Colorado, Connecticut, and Massachusetts. Speakers reflected on the process of designing, implementing, and refining their models, including how stakeholders were engaged in model design and key program decisions.

IV. Moderated Q&A 

Moderator: Anne Smithey, CHCS