The Centers for Medicare & Medicaid Services (CMS) Innovation Center has announced four new regions in which practices will be eligible to apply for the agency’s new five-year Comprehensive Primary Care Plus (CPC+) model as part of Round 2 of the CPC+ initiative.
In April 2016, CMS announced a new initiative with the aim to transform how primary care is delivered and paid for in America. Building on the Comprehensive Primary Care initiative from 2012, the new CPC+ model is a five-year primary care medical home model beginning January 2017 that will enable primary care practices to care for their patients the way they think will deliver the best outcomes and to pay them for achieving results and improving care, CMS says. CPC+ includes two primary care practice tracks with incrementally advanced care delivery requirements and payment options to meet the diverse needs of primary care practices in the U.S.
CPC+ Round 1 supports 2,891 primary care practices, comprising 13,090 clinicians and serving more than 1.76 million Medicare beneficiaries.
CMS expects to select up to 1,000 primary care practices in CPC+ Round 2 in four regions: Louisiana, Nebraska, North Dakota, and the greater Buffalo Region of New York.
Eligible practices located in these regions can apply to participate in CPC+ Round 2 through an online portal until July 12, 2017, CMS announced.
CPC+ Round 1 began on January 1, 2017 and Round 2 will begin in January 2018.
According to CMS, through a unique public-private partnership with 54 aligned payers in 14 regions in the CPC+ Round 1 and seven payers in four regions in CPC+ Round 2, the CPC+ payment redesign gives practices the additional financial resources and flexibility they need to make investments that will improve quality of care and reduce the number of unnecessary services their patients receive. CPC+ provides practices with a robust learning system, as well as actionable data feedback, to guide their decision making. The care delivery redesign ensures practices in each track have the infrastructure to deliver better care to result in a healthier patient population.
The five-year CPC+ model is designed to help primary care practices:
• Support patients with serious or chronic diseases to achieve their health goals;
• Give patients 24-hour access to care and health information;
• Deliver preventive care;
• Engage patients and their families in their own care; and
• Work together with hospitals and other clinicians, including specialists, to provide better coordinated care.
CPC+ is an opportunity for practices of diverse sizes, structures, and ownership who are interested in qualifying for the incentive payment for Advanced Alternative Payment Models through the proposed Quality Payment Program, the agency says. CMS estimates that up to 5,000 primary care practices serving an estimated 3.5 million beneficiaries could participate in the model. Primary care practices will participate in one of two tracks. In Track 1, CMS will pay practices a monthly fee in addition to regular Medicare fee-for-service payments. In Track 2, practices will receive the monthly fee, as well as a hybrid of reduced Medicare fee-for-service payments and up-front comprehensive primary care payments to allow greater flexibility in how practices deliver care.