North Dakota Comprehensive Primary Care Plus
Program Location:
ND
Number of Practices:
26
Payer Type:
Multi-Payer
Parent Program:
Payers:
Blue Cross Blue Shield of North Dakota
Reported Outcomes
Description:
North Dakota was selected to participate in round 2 of a 5-year test demonstration of Comprehensive Primary Care Plus (CPC+). CPC+ is an advanced primary care medical home model that rewards value and quality through innovative payments that support comprehensive care. CPC+ is an initiative developed by CMS that transitions Medicare fee-for-service to value based payments in collaboration with Medicaid and commercial payers in selected regions. CPC+ Round 2 regions were selected based on payer alignment and market density to ensure that CPC+ practices have sufficient payer supports to make fundamental changes in their primary care delivery. Payer partners, and care providers in North Dakota have partnered with Medicaid in a project that aims to strengthen primary care through regionally-based multi payer payment reform and care delivery transformation. This unique public-private partnership gives practices additional financial resources and flexibility to make investments, improve quality of life, and reduce the number of unnecessary services patients receive.
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.
