The Centers for Medicare & Medicaid Services (CMS) has announced a new primary care medical home model aimed at strengthening primary care and reducing overall health care costs.
The Comprehensive Primary Care Plus (CPC+) model will include two tracks through which primary care practices can participate. Practices in both tracks will make changes to how they deliver care to patients through five identified functions:
- access and continuity
- care management
- comprehensiveness and coordination
- patient and caregiver engagement
- planned care and population health
Practices participating in Track 1 will receive regular Medicare fee-for-service payments, as well as a monthly payment per beneficiary for care management. Practices participating in Track 2 will receive an upfront, comprehensive primary care payment (CPCP). These CPCP payments are a hybrid of Medicare fee-for-service payments and a percentage of their expected reimbursement. Practices participating in Track 2 will commit to more comprehensive care delivery changes using health information technology.
Practices in each track also will be eligible for performance-based incentive payments. These payments will be made at the beginning of the performance year, but must be repaid if practices do not meet quality and performance thresholds.
CMS is currently accepting proposals from partner payers through June 1 and will begin accepting applications by interested practices July 15. The deadline for applications is Sept. 1.
Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.