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CMS Announces Regions for Primary Care Medical Home Model

The Centers for Medicare & Medicaid Services (CMS) has announced 14 regions to participate in its comprehensive primary care plus (CPC+) model.

CPC+ is an advanced primary care medical home model aimed at strengthening primary care and reducing overall health care costs. These regions were selected, based on insurer interest and coverage:

  • Arkansas
  • Colorado
  • Hawaii
  • Kansas and Missouri (Greater Kansas City Region)
  • Michigan
  • Montana
  • New Jersey
  • New York (North Hudson-Capital Region)
  • Ohio and Kentucky (Ohio and Northern Kentucky Region)
  • Oklahoma
  • Oregon
  • Pennsylvania (Greater Philadelphia Region)
  • Rhode Island
  • Tennessee

The model will include two tracks through which primary care practices can participate and make changes to how they deliver patient care. Practices participating in Track 1 will receive Medicare fee-for-service payments, as well as a monthly payment per beneficiary for care management. Practices participating in Track 2  those that commit to more comprehensive care delivery changes using health information technology 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.

Additionally, participants in both tracks will be eligible for performance-based incentive payments. These payments will be made at the beginning of the performance year and must be repaid if practices do not meet quality and performance thresholds.

Primary care practices in the selected regions may submit applications until Sept. 15. The model is scheduled to launch in January 2017.

Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Rachel Schwartz is a policy associate at America's Essential Hospitals.