As part of the agency-wide shift from fee-for-service to value-based payment models, the Centers for Medicare and Medicaid Services now is soliciting physician practices in 14 parts of the country to participate in a wide-scale medical home model that will reward doctors for outcomes. Monday, CMS opened the application period for the Comprehensive Primary Care Plus program and is taking applications through Sept. 15.
CMS unveiled CPC+ in April as an extension of Comprehensive Primary Care Initiative that began in October 2012 and is scheduled to expire at the end of 2016. CPC+, hatched in the Center for Medicare and Medicaid Innovation, will start in January, as CMS continues on a path to have at least half of traditional Medicare fee-for-service payments converted to alternative payment models by 2018.
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CPC+ aims to help primary care practices coordinate care, offer preventive health services, engage patients in their own care and help those with serious or chronic illnesses set and work toward health goals. Practices also will be expected to provide patients with on-demand, 24/7 access to their health information, according to CMS.
CPC+ is a public-private partnership in 14 regions involving Medicare, state Medicaid programs and private payers banding together to support primary care practices.
“We see CPC+ as the future of primary care in the U.S. and are pleased to partner with payers across the country that are aligned in this mission to transform our healthcare system,” CMS Deputy Administrator Dr. Patrick Conway said in a prepared statement. “This model allows primary care practices to focus on what they care about most – serving their patients’ needs when and how they choose.”
Practices participating in CPC+ will have to choose from one of two tracks. One will offer a monthly patient management fee on top of normal fee-for-service payments. The other provides a lower fee-for-service reimbursement plus “comprehensive” primary care payments to cover services for patients with physical or behavioral health conditions, according to CMS.
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CMS promises up-front performance-based incentive money to practices on both tracks that the providers must return if they fail to meet certain quality and utilization standards.
The new CPC+ model is available to primary care practices in any part of the following states: Arkansas, Colorado, Hawaii, Michigan, Montana, New Jersey, Ohio, Oklahoma, Oregon, Rhode Island and Tennessee. Other regions involved include: the Greater Kansas City region of Missouri and Kansas; the North Hudson-Capital region of New York; Philadelphia and environs within the state of Pennsylvania; and several counties in Northern Kentucky that border Ohio.
The CMS Press Office did not respond to a request for further comment.
Photo: Flickr user Eva Blue
