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Date: Aug. 22, 2016

Contact: Tamiya Williams, CMPE | |

CMS Largest Initiative: CPC+ Future of Primary Care

CPC+ 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. 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.

CPC+ is a multi-payer model - Medicare, state Medicaid agencies, and private insurance companies partner together to support primary care practices.  By aligning Medicare, Medicaid, and private insurance, CPC+ moves the health care system away from one-size-fits-all, fee-for-service to a model that supports clinicians delivering the care that best meets the needs of their patients and improves health outcomes.

 

Medical Home Standards

Team-Based Healthcare Delivery

Patient Centered Access

Population Health Management

Care Management and Support

Performance Measurement & Quality Improvement

Care Coordination & Care Transition

Ohio is one of the states/regions that has been selected for CPC+. Eligible practices may apply between August 1 and September 15, 2016 to participate in CPC+ by clicking this link:  https://app1.innovation.cms.gov/cpcplus

PCP’s are being offered financial support by the following companies to help sustain their practices while they transform into a Medical Home:

  •  Anthem/Enhanced Primary Care Program
  • HealthSpan
  • Aetna
  • Humana
  • Healthcare Collaborative
  • Ohio Patient Centered Primary Care Collaborative/Ohio Department of Health

Provisional Payer Partners for Ohio are as follows:

  • Aetna
  • Anthem
  • Aultman Health Foundation
  • Buckeye Health Plan
  • CareSource
  • Gateway Health Plan Ohio
  • Medical Mutual Ohio
  • Molina Healthcare of Ohio
  • Medicaid
  • Paramount Health Care
  • SummaCare
  • The Health Plan
  • United Healthcare

Practices that are accepted into the CPC+ will receive per-member-per-month payments ranging from $15-$100. Also, under the proposed rules for MACRA, they would also be Advanced Payment Models that get automatic 5% bonuses on all Medicare Part B billing.

In addition to financial support the following HIT Vendors have pledged to help practices through the CPC+ process:

  • Allscripts Healthcare, LLC  -Certified for MU
  • Athenahealth, Inc -Certified for MU
  • Cerner Corporation -Certified for MU
  • eClinicalWorks -Certified for MU
  • GE Centricity -Certified for MU
  • Greenway Health -Certified for MU
  • HealthFusion, Inc -Certified for MU
  • M3 Information
  • NextGen Healthcare -Certified for MU
  • Phytel -Certified for MU
  • Wellcentive

Follow the link below for an explanation on CPC+ program

https://innovation.cms.gov/initiatives/Comprehensive-Primary-Care-Plus

Follow the link below to learn more about what states and regions were selected for CPC+

http://blog.ncqa.org/cpc-announces-regions-view-ncqa-directory-as-a-tool/