“Today, the U.S. Centers for Medicare & Medicaid Services (CMS) announced the 14 regions that will participate in the Comprehensive Primary Care Plus (CPC+) Initiative, the largest-ever initiative to transform and improve how primary care is delivered and paid for in America. CMS also opened the application period for practices in the selected regions that wish to participate in CPC+. They can apply from now through Sept. 15.
The Patient-Centered Primary Care Collaborative (PCPCC) is pleased that all seven of the original CPC regions will continue to support multi-payer primary care payment reform by participating in CPC+. Early evaluations of the original CPC demonstrated measured improvement in total monthly Medicare expenditures ($11 per beneficiary per month), as well as some summary measures of quality of care for patients with diabetes. In addition, the independent evaluators identified important opportunities to further scale and spread high performing primary care. These ‘lessons learned’ are incorporated into CPC+ and represent the next step in advanced primary care for both care delivery and payment design.
The CPC+ initiative represents the future of health care. It encourages the type of comprehensive primary care that not only leads to more effective, efficient, and patient-centered care but also embraces value. It moves us a significant step forward in providing the necessary payment structures to enable primary care providers to operate as high functioning patient-centered medical homes.
Participating CPC+ practices will qualify as Advanced Alternative Payment Models (AAPMs) under the Medicare Access and CHIP Reauthorization Act (MACRA), or new Quality Payment Program (QPP). As an AAPM, CPC+ practices can reap significant financial rewards in 2019 and beyond under the QPP.
As we await the final rule (due in November) outlining specifics of MACRA implementation, we fully support the inclusion of all CPC+ practices as AAPMs. We also strongly advocate for an expansion of pathways, in addition to CPC+, for primary care practices to qualify as AAPMs. Innovative practices should leap at the opportunity for enhanced payment as they shift away from the traditional and inequitable fee-for-service reimbursement model.
We encourage stakeholders to access the CPC+ resources available online:
The PCPCC has long advocated for this type of multi-payer evolution in health delivery and payment reform. Decades of research has shown that health care systems built on a strong foundation of comprehensive primary care lead to better care, smarter spending, and healthier people. CPC+ combines the power of comprehensive primary care with much needed payment reform."
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Editor's Note: To arrange an interview with Marci Nielsen, contact Amanda Holt, 202-640-1212, or amanda@pcpcc.org. We also invite you to access our online Primary Care Innovations and PCMH Map where we track these types of advanced primary care programs nationwide. You can view the CPC+ initiative listed on our map here.
About the PCPCC
Founded in 2006, the PCPCC is a not-for-profit membership organization dedicated to advancing an effective and efficient health care system built on a strong foundation of primary care and the patient-centered medical home (PCMH). The PCPCC achieves its mission through the work of its volunteer members, Stakeholder Centers, experts, and thought leaders focused on key issues of delivery reform, payment reform, patient engagement, and benefit design to drive health system transformation. For more information, or to become an executive member, visit www.pcpcc.org.