North Hudson-Capital Region (NY) Comprehensive Primary Care Plus

Program Location: 
NY
Number of Practices: 
149
Payer Type: 
Multi-Payer
Payers: 
Empire Blue Cross Blue Shield
Capital District Physicians’ Health Plan (CDPHP)
MVP Health Plan
Inc.

Reported Outcomes

Description: 

The New Hudson-Capitol Regions of New York was one of four regions selected to participate in round 2 of the Comprehensive Primary Care Plus Initiative (CPC+) administered by CMS. 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. 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. Payers in the New York Regions 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.

 

CMS Comprehensive Primary Care Plus

Improved Access: 

Now available in 18 regions.

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