CMS Announces Launch of New Multi-Payer Initiative to Improve Primary Care, Shift from Volume to Value
This week, the Centers for Medicare & Medicaid Services (CMS) announced the launch of a new advanced primary care medical home model—Comprehensive Primary Care Plus (CPC+)—which it has called its "largest-ever" payment reform and care delivery transformation initiative.
Beginning in January 2017, the test model will be implemented over five years in up to 20 regions (the regions are yet to be determined) and could include as many as 5,000 primary care practices encompassing 20,000 or more physicians and other healthcare professionals and 25 million patients.
The selected practices will participate in one of two tracks—with incrementally advanced care delivery requirements and payment options—designed to help them support patients with serious or chronic diseases; give patients 24-hour access to care and health information; deliver preventive care; engage patients and their families in their own care; and work with hospitals and other clinicians, including specialists, to provide better coordinated care.
CMS is accepting payer proposals through June 1, 2016. It will then determine which regions have sufficient interest from multiple payers to support practices' participation in CPC+. CMS will then announce the selected regions and accept practice applications in those regions from July 15 through September 1, 2016.
The selected practices will benefit from a robust learning system, actionable patient-level cost and utilization data feedback, and up-front incentive payments ($2.50 per beneficiary per month for track one, $4 PBPM for track two) that they will either keep or repay based on their performance of quality and utilization metrics.