Major payers including Aetna, UHC sign on to California primary care initiative

Major payers and providers are joining forces in California to back advanced primary care. 

Six organizations in the state have signed a memorandum of understanding, agreeing to invest in boosting access to advanced primary care, a model that emphasizes whole-person care for high-quality outcomes. The goal is to strengthen primary care access in the Golden State by making it easier for practices to switch to a high-performing, value-based model.

The California Advanced Primary Care Initiative is jointly backed by the California Quality Collaborative, an arm of the Purchaser Business Group on Health, and the Integrated Healthcare Association. Aetna, Aledade, Blue Shield of California, Health Net, Oscar Health and UnitedHealthcare signed on to the MOU.

“This initiative reflects our understanding that the impact of any one payer alone is limited,” said Peter Long, executive vice president of strategy and health Solutions at Blue Shield, in a statement. “That’s why Blue Shield is committed to partnering with our peer payers and providers to scale delivery of high-quality primary care across the state. Ultimately, we know this is what is best for our members, and we all must work together to make this vision a reality.”

As part of the MOU, the six insurers agree to pursue several goals, including:

  • Transparency: The partners will report investment in primary care as well as adoption of value-based payment models, based on a measure set developed by CQC and IHA. These metrics will allow purchasers, insurers and providers to identify PCPs that are delivering the best results.
  • Payment: Agree to a value-based payment model in primary care that enables team-based care, flexibility and the right care at the right time.
  • Investment: Collaborate to set quantitative goals to increase investment in primary care without driving up the total cost of care.
  • Practice transformation: Offer assistance to primary care providers, allowing them to roll out the models necessary for value-based care, integrated behavioral healthcare and to reduce disparities.

CQC and IHA have been working together since 2019 to develop shared metrics and standards for tracking advanced primary care.

“Primary care is the heart of all health care,” says Jeff Hermosillo, California market president at Aetna, in a statement. “This innovative initiative will help ensure accessible, affordable and high-quality primary care to improve the well-being of all Californians."

"Working together with our peers, providers, plan sponsors and members, we are committed to primary care that makes a difference in people’s lives," Hemosillo said.