Overview
Making Care Primary (MCP) is the CMMI primary-care payment model that launched July 2024 in eight states — Colorado, Massachusetts, Minnesota, New Mexico, New Jersey, New York, North Carolina, and Washington. It builds on Primary Care First with broader practice eligibility, a simplified payment structure, and a 10-year model duration designed to give participating practices a sustained transformation runway.
MCP offers three progressive tracks. Track 1 is an onboarding track for practices new to value-based payment, paying a modest care-management fee alongside standard FFS billing. Track 2 shifts the majority of revenue to a partial population-based payment with retained some FFS. Track 3 moves practices to full prospective primary-care payment with zero or minimal FFS billing for primary-care services. Practices advance between tracks over the model's duration based on readiness.
Payment structure includes a care-management fee (risk-adjusted per-beneficiary-per-month), an enhanced services payment for specific care-coordination activities, and performance-based incentive payments tied to quality and total-cost-of-care outcomes. The exact mix shifts across tracks — Track 3 practices receive the largest population-based component.
Health-equity is a first-order priority. MCP participants must meet specific equity-related requirements including data stratification by demographic factors, targeted outreach to underserved populations, and reporting on equity-adjusted quality measures. CMMI has explicitly described health equity as a core design goal for MCP, distinguishing it from predecessor primary-care payment models.
Care-model transformation is more intensive than Primary Care First. Participants commit to specific transformation activities including care team expansion (pharmacists, behavioral-health clinicians, community health workers), after-hours access capacity, chronic-condition management programs, and integration with community-based organizations addressing social determinants.
For RCM operations, MCP participation introduces population-payment cash flow patterns alongside FFS receivables. Track 1 practices continue to bill standard E&M codes with a modest added care-management stream; Track 3 practices bill population-payment-only for primary care, materially changing revenue mix and AR patterns. Finance teams must track dual revenue streams and forecast population-payment reconciliations.
MCP is expected to inform the next generation of CMS primary-care payment and may serve as a template for broader FFS-to-population-payment transition if the program demonstrates sustained cost and quality improvement.
Mature RCM teams treat Making Care Primary (MCP) Model as a lever rather than a report line. The practical move is to set a weekly delta target against the 90-day baseline and make Making Care Primary (MCP) Model the headline metric a biller owner is accountable for, with primary care first and alternative payment model as the second-tier drivers they report on beneath it. The trap worth naming is denominator drift — a change in payer mix, service line, or even calendar workdays can move Making Care Primary (MCP) Model without any operational issue, so the monthly review should always include a volume-normalized cut alongside the raw number. Reviewers also recommend stratifying by top five payers, because a single payer's policy change will frequently distort an all-payer Making Care Primary (MCP) Model reading.
Industry benchmark
MCP enrollment: ~700 practices across eight states (2024 launch). Track 1 practices continue near-FFS revenue patterns; Track 3 practices operate under prospective population payment for primary care.
Worked example
A primary-care practice in North Carolina enters MCP Track 1 with 3,800 attributed Medicare beneficiaries. Monthly care-management fee of $18 PBPM yields approximately $68,400 added monthly revenue atop continuing FFS billing. After two years the practice advances to Track 2, shifting 40% of primary-care revenue to population payment with increased care-management fees.
Frequently asked questions — Making Care Primary (MCP) Model
Is MCP available nationally?
Not yet — the 2024 launch covered eight states. CMS may expand geographic eligibility in future model years pending early performance evaluation.
Can MCP practices also be in ACOs?
Yes, subject to CMS alignment rules. Many MCP practices maintain ACO participation for non-primary-care financial mechanics; specific rules govern overlap.
How does MCP differ from Primary Care First?
MCP has broader practice eligibility, three progressive tracks instead of PCF's single structure, an explicit health-equity mandate, and a 10-year model duration providing sustained transformation runway.
Disclaimer
This glossary entry is operational reference for revenue-cycle and medical-billing professionals. It is not legal, clinical, or contractual advice. Industry benchmarks cite named public sources where available; always verify against the current guidance from the authority body before relying on a number in a contract, policy, or compliance filing.