Practices Making Good Progress on Achieving Care Management Milestones

Halfway through the four-year Comprehensive Primary Care (CPC) initiative(innovation.cms.gov) CMS' Center for Medicare and Medicaid Innovation launched in October 2012, two recent reports shed light on what about 1,300 family physicians participating in the groundbreaking program have learned.

The first report summarizes participating practices' expenses and revenue; the second provides a snapshot of the practices' performance to date. Together, they offer insight into the progress of this multipayer initiative designed to foster collaboration between public and private health care payers to strengthen primary care.

According to a CPC Fast Factsreport(innovation.cms.gov) that discusses the initiative's 2013 practice revenues and expenses, 496 primary care practices, 2,494 providers and 2,534,506 patients were participating in the project as of January 2014.

In addition, CPC practices in seven areas -- Arkansas, Colorado, New Jersey, New York, Ohio/Kentucky, Oklahoma and Oregon -- had received $141 million in care management payments from Medicare and other payers during the 2013 program year.

The median total care management fee paid to individual practices between October 2012 and December 2013 was about $228,000, or close to $70,000 per provider. Care management fees paid out among the regions ranged from a high of $29.2 million in Ohio/Kentucky to $15.1 million in Oklahoma.

In all, CPC practices spent about $116 million on CPC-related activities in the 2013 program year. The report showed that 51 percent of that spending across all regions -- nearly $59 million -- went toward care management fees, or risk stratification and care management activities.