Bill > H1370

This bill aims to strengthen primary care in Massachusetts by establishing a comprehensive framework to increase investment in and improve the quality of primary care services. The legislation creates a Primary Care Council consisting of 25 members from various healthcare and industry organizations, which will develop a voluntary prospective payment model for primary care providers. This model includes a monthly per-patient payment that can be adjusted based on providers' adoption of "primary care transformers" (innovative services like integrating behavioral health, employing community health workers, and offering telehealth), quality of patient care, and the medical and social complexity of their patient panel. The bill sets progressive targets for primary care expenditures, starting at 10% of total healthcare expenditures in 2027 and rising to 15% by 2029. Healthcare entities that fail to meet primary care expenditure targets may be required to submit performance improvement plans, and a new Primary Care Stabilization Fund will be established to support the implementation of these initiatives. The legislation also mandates that primary care services under this model will have no cost-sharing for patients and requires at least 95% of payments to go directly to primary care providers, with the goal of strengthening and expanding primary care access and quality across Massachusetts.

Health and Social Services

https://malegislature.gov/Bills/194/H1370