California Advanced Primary Care Initiative
PBGH’s California Quality Collaborative (CQC) has been working for over a decade to improve primary care. Through stakeholder partnership, this work has culminated in the development of shared attributes and measures that enable purchasers, health plans and providers to identify primary care practices in a given market that are delivering the kind of care research tells us will bring about the best results for patients.
The California Advanced Primary Care Initiative, a joint effort by CQC and the Integrated Healthcare Association (IHA), is a continuation of that effort to strengthen the primary care delivery system throughout the state by building and scaling a primary care model that emphasizes comprehensive, team-based and person-focused care, the integration of behavioral and physical health services and high-quality outcomes.
Multi-Payer Alignment
CQC and the IHA convened a coalition of large commercial health care payers to work together to enable primary care practices to transform to a high-performing, value-based care model that reduces costs and improves quality and equity. The payers currently participating are Aetna, Aledade, Anthem Blue Cross, Blue Shield of California and Health Net.
These payers have signed a memorandum of understanding (MOU) committing to this coordinated effort through 2025. The MOU has four areas of focus:
1. Transparency: Report primary care investment, adoption of value-based payment models that support the delivery of advanced primary care and performance on the Advanced Primary Care measure set jointly developed by CQC and IHA.
2. Payment: Adopt an agreed upon value-based payment model for primary care providers that offers flexibility, supports team-based care delivery and incentivizes the right care at the right time.
3. Investment: Collaboratively set increased primary care investment quantitative goals without increasing the total cost of care.
4. Practice Transformation: Provide technical assistance to primary care practices working to implement clinical and business models for success in value-based payment models, integration of behavioral health and reduction of disparities.
Additional payer organizations are encouraged to sign onto the MOU and join this effort. Contact Lindsay Petersen to learn more.
Programs
Payment Model Demonstration Project (2024-2025)
Read More about Payment Model Demonstration Project (2024-2025)The Payment Model Demonstration Project will test a common value-based payment model with approximately 30 independent practices in California to strengthen primary care delivery.
Advanced Primary Care Measurement Pilot (2022-2023)
Read More about Advanced Primary Care Measurement Pilot (2022-2023)The measurement pilot tested the effectiveness of the Advanced Primary Care Measure Set and practice performance in California.
Featured
Exploring Capitated Payment for Primary Care in California
Hybrid payments that include capitation offer a promising alternative to traditional fee-for-service models, focusing on quality over quantity to enhance patient outcomes and system efficiency.
Empowering Care: The Role of Alternative Payment Model Design in Advancing Equity
Alternative Payment Models (APMs), incentivizing clinicians to provide high-quality, cost-efficient care beyond traditional fee-for-service payments, hold immense potential to revolutionize health care delivery, expanding access, improving outcomes and addressing health disparities.
From Data to Delivery: Measuring Advanced Primary Care in California
CQC and IHA executed a pilot project in California, bringing together four large health care purchasers — Covered California, California Public Employees’ Retirement System (CalPERS), eBay and San Francisco Health Services System — and 13,055 primary care practices.
California Providers and Health Plans Sign Agreement to Expand Investment and Increase Access to Advanced Primary Care
As part of a new multi-stakeholder initiative, six health care organizations serving California have signed a memorandum of understanding (MOU) to increase investment in and access to ‘advanced primary care.’
Strengthening Primary Care: A Pilot with Four Large Purchasers
Together with the Integrated Healthcare Association (IHA), PBGH brought together four large health care purchasers in California to pilot this set of performance measures that emphasize patient experience and outcomes.
Using Primary Care’s Potential to Improve Health Outcomes
Through successive initiatives and in collaboration with a diverse group of committed stakeholders, PBGH has spearheaded efforts to create a blueprint for “advanced primary care.”
Quality Improvement Project to Modernize Primary Care Launched
Covered California, the California Public Employees’ Retirement System (CalPERS) and the Purchaser Business Group on Health (PBGH) are partnering to launch a pilot program to promote improvement in primary care which will benefit all Californians.
Resources
Issue Brief: Capitated Payment for Primary Care in Self-Funded Health Insurance Arrangements in California
Common Value-Based Payment Model Guide for Primary Care Physicians & Payers
California Advanced Primary Care Initiative | 2023 End-of-Year Report
Issue Brief: Recommendations to Advance Equity Through Payment Models
Issue Brief: Measuring Advanced Primary Care in California
California Advanced Primary Care Roadmap
Charter, Goals and Milestones
California Advanced Primary Care Initiative Overview
Webinar: The Future of Primary Care in California
MOU Among California Payers in Support of Multi-payer Partnership
The Journey to Advanced Primary Care
Advanced Primary Care Measurement Pilot
Advanced Primary Care Measure Set
Advanced Primary Care: Defining a Shared Standard
Announcements
California Providers and Health Plans Sign Agreement to Expand Investment and Increase Access to Advanced Primary Care
As part of a new multi-stakeholder initiative, six health care organizations serving California have signed a memorandum of understanding (MOU) to increase investment in and access to ‘advanced primary care.’
Quality Improvement Project to Modernize Primary Care Launched
Covered California, the California Public Employees’ Retirement System (CalPERS) and the Purchaser Business Group on Health (PBGH) are partnering to launch a pilot program to promote improvement in primary care which will benefit all Californians.
Past Events and Training
Measuring Advanced Primary Care in California: Pilot Results and the Path Forward
Join this CQC webinar to hear results and stakeholder reactions to the California Advanced Primary Care Measurement Pilot and explore the best next steps for the California health care system.
CQC Webinar – Advanced Primary Care: Piloting Practice Level Measurement
A webinar describing the next step in California’s journey to scale high quality, efficient and patient-centered primary care, also known as Advanced Primary Care (APC).