Ohio & Northern Kentucky Comprehensive Primary Care Plus
Program Location:
OH
Payer Type:
Multi-Payer
Parent Program:
Payers:
Aetna
Anthem Blue Cross Blue Shield
AultCare
Buckeye Health Plan
CareSource
Gateway Health Plan of Ohio Inc.
HealthSCOPE Beneifts
Medical Mutual of Ohio
Molina Healthcare of Ohio Inc.
Medicaid
Paramount Health Care
SummaCare Inc.
UnitedHealthcare
Reported Outcomes
Description:
The state of Ohio and regions of Northern Kentucky were selected as one of 18 regions nationwide to participate in Comprehensive Primary Care Plus (CPC+). This project is a partnership among Medicare, Medicaid, commercial insurers and care providers that aims to strengthen primary care through regionally-based multi-payer payment reform and care delivery transformation over a five year period. CPC+ is a unique public-private partnership that gives practices additional financial resources and flexibility to make investments, improve quality of life, and reduce the number of unnecessary services their patients receive. The payers in the states of Ohio & Kentucky have agreed to invest in 555 primary care practices by paying monthly care management fees which the practices use to improve patient care.
Payment Model:
Practices will enter one of two program tracks. The track dictates the care delivery capabilities practices will develop and the payment structure they will receive.
CPC+ includes two primary care practice tracks with incrementally advanced care delivery requirements and payment options to meet the diverse needs of primary care practices in the United States. The two tracks, which are comprehensive care and financial support will dictate the care delivery capabilities practices will develop and the payment structures that they receive. Practices in both tracks will make changes in the way they deliver care, centered on key Comprehensive Primary Care Functions: (1) Access and Continuity; (2) Care Management; (3) Comprehensiveness and Coordination; (4) Patient and Caregiver Engagement; and (5) Planned Care and Population Health.
