HHS Offers States $275M for Care Delivery, Payment Models

Kaye says coordinating scare primary care resources will be particularly important as millions of people obtain health insurance coverage in the coming years under the Affordable Care Act.

"People coming through the door, particularly in the expanded population, they are unlikely to have had the preventive and primary care that they need because they wouldn't have had coverage. They are going to come through the door looking for that. We know how stretched primary care providers are and how little time they get to spend with patients and now they are going to have more patients," she says. 

"In some senses primary care has to rearrange itself, perhaps move more toward a team-based approach with the medical home program that some states have launched."

"Another thing they'll need is to agree on a common set of metrics so you know the primary care provider has kept the patient well, so the providers aren't being pulled in several different directions and they can really focus on providing care," she says. "It isn't so much that there is confusion about what the goals are and what are the possible strategies for getting there. What they need is the part that figures out what strategies are going to work to get me down that path."

The state applications for funding will be reviewed by CMS and its independent Office of the Actuary and by an independent review panel. CMS said it expects to offer a second round of Model Testing awards next year.