BROWSE CASE STUDIES Case Studies > The New England States’ All-Payer Report on Primary Care Payments

The New England States’ All-Payer Report on Primary Care Payments

December 2020

CATEGORIES:

Consumers, Providers, Researchers, Insurance Department, Medicaid, Health Reform

FILTERS:

Utilization, Cost, Health, Pharmacy, Dental, Commercial, Medicaid, Medicare

CONTACT

New England States Consortium Systems Organization
info@nescso.org

In 2017, New England States Consortium Systems Organization (NESCSO), a nonprofit corporation organized and directed by the six New England states’ health and human services agencies and the University of Massachusetts Medical School, formed a Primary Care Investment Workgroup (“Workgroup”). The Workgroup includes representatives from all six New England states – Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont. The Workgroup’s main goal has been to advance a “Vision for Patient Centered Primary Care” by exploring opportunities for sharing state strategies and activities. During meetings over the past three years, the group has engaged in discussions regarding each state’s approach to primary care payments, policy environments, data capabilities, and potential opportunities for collaboration. In 2019, the Primary Care Investment Workgroup proposed to use “standardized” data to produce a “The New England States’ All-Payer Report on Primary Care Payments” focused on how states incentivize and measure primary care payments as a percentage of total healthcare expenditures. The purpose of the report is to use standardized data to identify the percentage of all-payer primary care spending relative to overall healthcare spending in each state and to provide a framework to evaluate whether the states’ investments in primary care reflect the importance and value of primary care in each state. The Workgroup chose this focus with the intention of building on early evidence that an increased percentage of total payments invested in primary care is associated with improved quality, utilization, and cost outcomes. The Workgroup envisioned establishing a baseline of comparable information and benchmarks as an important tool to help guide their states’ policies on primary care payments and to monitor the impact of those policies over time. In 2020, NESCSO agreed to finance the Workgroup’s proposal by engaging Onpoint Health Data to provide the analytic services needed to support this project. The Milbank Memorial Fund provided supplemental funding in support of this project.