The upfront payments under the Comprehensive Primary Care Initiative, which totaled about $400,000 a year, have allowed SAMA Health-Care Services in El Dorado to “completely transform our clinic into a team-based system”, clinic administrator Pete Atkinson said. The original model showed transformation but had not yet shown savings after 2 years.
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The Ohio initiative kicks off January 1, 2017 at the same time the federal Centers for Medicare and Medicaid Services will launch a similar program – the Comprehensive Primary Care Plus, or CPC+ – program, authorizing Medicare to pay physicians monthly bonuses for primary-care visits. Several proposals in the 2017 Physician Fee Schedule seek to compensate practices that bring behavioral health and primary care under one roof, improve advanced care planning, and prevent diabetes.
According to a statement, CMS estimates that 5000 primary care practices could take part in CPC+, reaching 3.5 million people.
Practices selected for the CPC+ program will be invited to join the Ohio CPC program.
Brandi Hinkle, Arkansas Department of Human Services deputy chief of communications, said the program will help DHS expand its patient-centered medical home program for beneficiaries of Medicaid, the program that serves the poor, the disabled and the aged. The aim of the latest model is to enhance health outcomes and cut expenses not just for Medicare beneficiaries, but also for consumers participating in commercial plans and other coverage options, including insurer-managed Medicaid plans.
For a second time, New Jersey has been chosen as one of a select set of testing grounds for a massive, national public-private partnership created to improve primary care for patients and reduce the cost of healthcare for society at large.
The original model launched in 2011 in seven regions: Arkansas, Colorado, New Jersey, New York’s Capital District-Hudson Valley region, OH and Kentucky’s Cincinnati-Dayton region, Oklahoma’s greater Tulsa region and Oregon. The initiative’s other areas include the Greater Kansas City, Mo., area; NY state’s North Hudson Valley; Greater Philadelphia area; and an area, including all of OH and northern Kentucky.
The new program offers participating providers two payment tracks.
In short, participating physicians are expected to redesign their practices to support improved access and care continuity, care management, comprehensiveness and coordination, patient and caregiver engagement, planned care and population health management. For those in Track 1, CMS will pay a risk-adjusted monthly care-management fee for each Medicare patient (from $15 to $28, depending on the level of care needed) and can collect traditional fee-for-service reimbursements for their treatments. “Lourdes recently contracted with one “major payer” for bundled payments, he said, although it’s too early to have results”.
Additionally, GAO found that CMS does not adjust the Medicare UC payment for the Medicaid payments hospitals already receive to offset uncompensated care costs. However, because of the payment structure of this program, practices will ideally have the freedom to take on their own unique strategies. Also, the model includes performance-based incentives.
This week the Centers for Medicare & Medicaid Services (CMS) announced the 14 regions and states that will participate in its new primary care model, Comprehensive Primary Care Plus (CPC+).
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OH is taking a major step forward in its efforts to create a national model that will reward primary care providers who do more to keep patients well and hold down the total cost of care.
