I Am a Primary Care Champion

Chris Crowe

Chris Crowe, MD

Dr. Christopher Crowe is a primary care physician and co-founder of Catalyst Health Network (CHN), a clinically integrated network with over 1,000 primary care providers caring for more than 1 million patients across northern Texas. Dr. Crowe is passionate about collaborating with primary care practices using care management, technology, and prospective payment models. He is enthusiastic about alternative payment opportunities in Medicare, specifically Medicare Advantage plans and the ACO REACH program, because both options enable prospective payment for primary care, which Dr. Crowe credits with “creating a different mindset for operations and care delivery.”  

With prospective payment, also called capitation, primary care can innovate and remodel care, “separating care from time and place,” he notes, while “building better, long-term patient relationships.” For Dr. Crowe, the equation is simple: long-term relationships build trust, and trust supports behavior change. He calls out the role of pharmacists in CHN’s model as having an outsize impact on patient outcomes, and the CHN model empanels patients to physicians and pharmacists. It’s not about putting patients in siloed disease management services, it’s about whole person care. Dr. Crowe is excited to serve “dual-eligible” beneficiaries enrolled in both Medicare and Medicaid and to bring more resources to the home, where primary care teams can gather insights, solve problems, and build greater trust. 

Dr. Crowe affirmed the key pillars of the PCC Better Health NOW campaign—pivot resources to primary care, pay for better health outcomes, and remove barriers faced by patients and communities that stand in the way of better health.  He spoke recently to the Primary Care Collaborative’s board of directors with Tim Noel, CEO of United Healthcare’s (UHC) Medicare and Retirement division. Tim and Chris shared their constructive partnership in Medicare Advantage (MA), with Tim reporting that UHC’s most successful MA markets are those with primary care practices that function as described in the NASEM 2021 report, Implementing High-Quality Primary Care. Practices with a foundation of integrated teams, data, and financial accountability for quality and improvement are the core elements for success, according to Noel. Plans with full-risk, “delegated” models on average perform better clinically with MA’s quality stars program, and have higher benefit values and net promoter scores, according to Noel. United Healthcare views Medicare alternative payment models such as ACO REACH not as competitors to MA, but as opportunities for more practices to move away from fee-for-service, Noel remarked. 

Tim and Chris noted that commercial payers currently lag Medicare in transitioning to alternative payment models that support primary care capitation and partial capitation (hybrid). Chris observes the commercial market as having structural issues to overcome, with misalignment between payers, consultants and brokers. As a result, no party has a strong incentive to manage resources. He also identified pediatrics as an area where government and private payers both suffer from short-term horizons when it comes to investing in payment models that generate high value and better health for children who become healthier adults.   

occurring for primary care physicians that have opted out of the fee-for-service insurance market.

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