16 states to test comprehensive primary care program
CMS plans expansive 5-year test of risk-based medical home model.
Applications for physician organizations to participate in the federal government’s new medical home model program, the Comprehensive Primary Care Plus or CPC+, now are available.
The shift to the new programs is expected to place increased importance on information technology, as providers participating in the program will need population health and analytics capabilities to succeed in an accountable care environment.
Eligible practices in the 14 regions that will test the program can begin applying today through September 15 to participate in CPC+.
For now, CPC+ is limited to all or parts of 16 states that cover the regions, according to the Centers for Medicare and Medicaid Services. The agency estimates that as many as 5,000 primary care practices could participate and serve as many as 3.5 million Medicare, Medicaid and commercial insurance beneficiaries.
Practice may participate in one of two tracks. Under Track 1, CMS will pay a monthly fee in addition to the Medicare fee-for-service payment to practices that help chronic patients achieve health goals, offer 24-hour access to care and information, deliver preventive care and engage patients and families, and improve care coordination with other physicians and hospitals.
CPC+, or Track 2, is more comprehensive and riskier, covering patients with complex medical and behavioral needs. Providers in this track will receive prospective-based incentive payments they could keep or return at least in part to CMS, depending on their scores on quality and utilization metrics.
States participating in CPC+ include Arkansas, Colorado, Hawaii, Michigan, Montana, New Jersey, Oklahoma, Oregon, Rhode Island and Tennessee. Ohio also is statewide, and its program includes northern Kentucky. Kansas and Missouri will cover the greater Kansas City region, New York will cover the North Hudson-Capital region, and Pennsylvania will cover the greater Philadelphia region.
More information is available here.
The shift to the new programs is expected to place increased importance on information technology, as providers participating in the program will need population health and analytics capabilities to succeed in an accountable care environment.
Eligible practices in the 14 regions that will test the program can begin applying today through September 15 to participate in CPC+.For now, CPC+ is limited to all or parts of 16 states that cover the regions, according to the Centers for Medicare and Medicaid Services. The agency estimates that as many as 5,000 primary care practices could participate and serve as many as 3.5 million Medicare, Medicaid and commercial insurance beneficiaries.
Practice may participate in one of two tracks. Under Track 1, CMS will pay a monthly fee in addition to the Medicare fee-for-service payment to practices that help chronic patients achieve health goals, offer 24-hour access to care and information, deliver preventive care and engage patients and families, and improve care coordination with other physicians and hospitals.
CPC+, or Track 2, is more comprehensive and riskier, covering patients with complex medical and behavioral needs. Providers in this track will receive prospective-based incentive payments they could keep or return at least in part to CMS, depending on their scores on quality and utilization metrics.
States participating in CPC+ include Arkansas, Colorado, Hawaii, Michigan, Montana, New Jersey, Oklahoma, Oregon, Rhode Island and Tennessee. Ohio also is statewide, and its program includes northern Kentucky. Kansas and Missouri will cover the greater Kansas City region, New York will cover the North Hudson-Capital region, and Pennsylvania will cover the greater Philadelphia region.
More information is available here.
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