Leveraging Primary Care Population-Based Payments In Medicaid To Advance Health Equity

Health Affairs March 3, 2023
Kelsey Brykman, Rob Houston, Shilpa Patel, Anne Smithey

High-quality primary care is a critical tool to advance health equity within Medicaid, which includes many enrollees who identify as people of color. This population experiences long-standing health inequities due to factors including structural racism and historic underinvestment in safety-net institutions. To support higher-quality, more equitable primary care, there is growing consensus that payment reform is necessary. Medicaid primary care population-based payment (PBP) models—advanced value-based payment (VBP) approaches that pay provider organizations through upfront, flexible payments tied to quality incentives—offer a key means to improve primary care. At least five state Medicaid programs are actively pursuing such models, and many others are well-positioned to adopt primary care PBP approaches.

Primary care PBP models can be a powerful tool for advancing...

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