Primary Care Models

Primary care model attention is centering on Medicare’s ACCESS Model, where CMS’s attempt to expand advanced primary care creates immediate VBC tradeoffs around attribution, prospective payment, risk adjustment, and how much downside accountability smaller or tech-enabled primary care groups can realistically absorb. New analysis of ACCESS underscores that the model’s promise—stronger longitudinal primary care and better specialty integration—depends on resolving payment-design complexity, while MassHealth’s work on a primary care-specific risk adjustment model points to a parallel Medicaid priority: making capitated or hybrid primary care payments more accurate for safety-net and high-need populations. For ACOs, payers, and enablement vendors, the near-term implication is clear: success in next-generation primary care will hinge less on generic care management and more on precise risk adjustment, aligned incentives, and scalable navigation/data infrastructure that can close gaps without overwhelming practices (Health Affairs on Medicare ACCESS.