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 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 Integrated Healthcare Association (IHA) convened a coalition of six 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, Blue Shield of California, Health Net, Oscar and UnitedHealthcare.

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.

Advanced Primary Care Measurement Pilot

Together with IHA, PBGH brought together four large health care purchasers in California to pilot CQC’s set of practice-level performance measures that emphasize patient experience and outcomes. The Advanced Primary Care Measurement Pilot began in January 2022, and participating purchasers include Covered California, California Public Employees’ Retirement System (CalPERS), eBay and San Francisco Health Services System.

The information gained in the pilot can be used by purchasers and health plans to better connect patients to practices delivering the best primary care in the market and incentivize improvement for other providers, increasing the availability of Advanced Primary Care.

 

Program Contact

Lindsay Petersen
Senior Manager, Care Redesign
lpetersen@pbgh.org

Resources

MOU Among California Payers in Support of Multi-payer Partnership

The Journey to Advanced Primary Care

Advanced Primary Care: Measure Set

Advanced Primary Care: Defining a Shared Standard

Past Events and Training

March 30, 2022

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).