Primary Care Models

Primary care payment reform is moving toward more condition-specific, infrastructure-heavy models, with Medicare’s ACCESS model drawing scrutiny for its care-delivery tradeoffs, specialty integration challenges, and uneven appeal to digital health entrants—especially as cardiology and chronic-care stakeholders assess how much risk, workflow change, and technology enablement the model requires under Traditional Medicare (Health Affairs on ACCESS). In Medicaid and commercial markets, risk adjustment and specialty VBC are becoming central design questions: MassHealth’s work on a primary care-specific risk model and Blue Cross NC’s outcomes-based Advanced Kidney Care program show payers trying to align payment more tightly with patient