New Medicare Payment Model Aims To Improve Primary Care

The Centers for Medicare & Medicaid Services (CMS) has launched a new initiative, the Comprehensive Primary Care Plus (CPC+) model, its largest ever, that aims to transform and improve how primary care is delivered and paid for in the United States.

CMS developed this initiative as a way for health care providers to provide better and more personalized care for patients, to strengthen primary care in the United States, and to better spend health care dollars.
_______________________________________________________________________________________________________________________________________________________________________

RELATED CONTENT
New Medicare Payment System will be Quality Based
How Will ICD-10 Affect Physician Reimbursement?
_______________________________________________________________________________________________________________________________________________________________________

The CPC+ model can be implemented in up to 20 regions where there is sufficient interest from multiple payers to support participation and can accommodate 5000 practices, which can include more than 20,000 clinicians and the 25 million people they serve.

The new model will run from January 2017 through 2021 and builds on the 2012 Comprehensive Primary Care initiative, which expires at the end of 2016.

Primary care practices can choose to participate in 1 of 2 tracks. Those in track 1 will receive a monthly care management fee payment as well as the fee-for-service payments under the Medicare Physician Fee Schedule for activities. Practices in track 2 will receive a monthly care management fee payment and a hybrid of reduced Medicare fee-for-service payments and up-front comprehensive primary care payments for those services.

“Strengthening primary care is critical to an effective health care system,” said Dr. Patrick Conway, CMS deputy administrator and chief medical officer. “By supporting primary care doctors and clinicians to spend time with patients, serve patients’ needs outside of the office visit, and better coordinate care with specialists, we can continue to build a health care system that results in healthier people and smarter spending of our health care dollars. The CPC+ model represents the future of health care that we’re striving towards.”

—Amanda Balbi

Reference:
CMS launches largest-ever multi-payer initiative to improve primary care in America [press release]. Baltimore, MD: Centers for Medicare & Medicaid Services; April 11, 2016. https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2016-Press-releases-items/2016-04-11.html.