In 2016, Hawaii Medical Service Association (HMSA), the Blue Cross Blue Shield of Hawaii, launched the Population-based Payments for Primary Care (3PC) system. 3PC was a new population-based primary care payment model with quality bonuses and a global budget shared savings incentive. HMSA would eventually shift 550 primary care practitioners (PCPs) statewide to 3PC. The 3PC needed to be feasible within a primary care market with large numbers of independent PCPs and across all HMSA member types (commercial, Medicare Advantage, and Managed Medicaid).
This study evaluated the association between the 3PC system and changes in the primary outcome of quality and secondary outcomes of utilization and cost of care in its first year.