States from Multi-Payer Primary Care Transformation Projects Come Together

The Milbank Memorial Fund’s Multi-State Collaborative (MC) held its annual meeting in Detroit in November. Forty participants from 15 states or regions were represented. Each state or region in the group is involved in multi-payer primary care transformation—either through CMS’s Multi-Payer Advanced Primary Care Practice (MAPCP) demonstration, the Comprehensive Primary Care (CPC) Initiative, or their own program without CMS demonstration funding. (See the 2014 MC report.)

The meeting focused on several topics, including how best to evaluate the work of each collaborative project. The Fund has teamed up with Mathematica Policy Research, which is looking at the most effective methodology for evaluating the projects and identifying future evaluation strategies.

Mathematica presented some of the findings so far, including how examining large populations helps provide reliable data for evaluations, findings, and comparisons to other projects. As is to be expected, the more mature programs, those with a history of at least five years, have more credible data and are starting to see encouraging results. The Fund will publish Mathematica’s report of the evaluations in 2016.

Another topic discussed at the meeting was the importance of program governance and leadership and, in particular, the process of integrating multi-payer programs at the local level with other payment reform activities. Vermont’s leadership team shared its strategy in aligning its robust community-based primary care infrastructure with quality measurement and payment innovations emerging from the state’s Accountable Care Organizations, which are led and sustained at the local level.

“There is a lot of interest nationally in advanced primary care, as this work is often called,” explains Lisa Dulsky Watkins, director of the MC. “As these federally-supported programs come to their scheduled termination dates at the end of 2016, the MC is well situated to facilitate this conversation—and to help shape what federal support for multi-payer primary care transformation will be in the future.”