Partners in this effort include Centers for Medicare & Medicaid Services (CMS), state Medicaid agencies, commercial health plans, self-insured businesses and primary care providers.
Through CPC+, CMS will pay primary care practices a care management fee to support enhanced, coordinated services on behalf of Medicare fee-for-service beneficiaries. At the same time, participating commercial, state and other federal insurance plans are also offering enhanced payment to primary care practices designed to support them in providing high-quality primary care on behalf of their members.
This partnership ultimately allows physicians to enhance patient care in the following ways:
Offer longer and more flexible hours;
Use electronic health records;
Coordinate care with a patient’s other health care providers;
Better engage patients and caregivers in managing their own care;
Provide individualized, enhanced care for patients living with multiple chronic diseases.
“At UC Health we are always evaluating new and innovative ways to serve our patients better, and this partnership continues that commitment,” said Nita Walker, MD, SVP of Ambulatory Services. “The level of support offered by CMS empowers our primary care physicians to go even further in living out our system’s patient-centered focus.”
The five-year model started on Jan. 1, 2017, with CMS soliciting a diverse pool of commercial health plans, state Medicaid agencies, and self-insured businesses to work alongside Medicare to support comprehensive primary care. Public and private health plans in 14 regions across the country signed letters of intent with CMS to participate in this model. Practices were chosen based on their use of health information technology; ability to demonstrate recognition of advanced primary care delivery by leading clinical societies; service to patients covered by participating payer partners; participation in practice transformation and improvement activities; and diversity of geography, practice size and ownership structure.
CPC+ is administered by the Center for Medicare & Medicaid Innovation (CMS Innovation Center). The CMS Innovation Center was created by the Affordable Care Act to test innovative payment and service delivery models that have the potential to reduce program expenditures while preserving or enhancing the quality of care.