Comprehensive Primary Care Initiative
The Comprehensive Primary Care (CPC) initiative is a four-year multi-payer initiative designed to strengthen primary care. Since CPC?s launch in October 2012, CMS has collaborated with commercial and State health insurance plans in seven U.S. regions to offer population-based care management fees and shared savings opportunities to participating primary care practices to support the provision of a core set of five ?Comprehensive? primary care functions.
These five functions are:
(1) Risk-stratified Care Management;
(2) Access and Continuity;
(3) Planned Care for Chronic Conditions and Preventive Care;
(4) Patient and Caregiver Engagement;
(5) Coordination of Care across the Medical Neighborhood. The initiative is testing whether provision of these functions at each practice site ? supported by multi-payer payment reform, the continuous use of data to guide improvement, and meaningful use of health information technology ? can achieve improved care, better health for populations, and lower costs, and can inform future Medicare and Medicaid policy.
In an effort to advance the nation?s shift to a value-based payment methodology, CMS announced the launch of the Comprehensive Primary Care Plus (CPC+) initiative. The objective of this new program is to allow physicians to spend more time with patients and better coordinate care outside of the primary care office to achieve better outcomes. A focus will be put on patients with serious or chronic conditions.
CPC+
The CPC+ is a five year program which will begin January 2017 and will include up to 5,000 practices and 20,000 physicians in 14 regions. The program consists of five components:
? Access and Continuity
? Care Management
? Patient and caregiver Engagement
? Planned care and Population Health
? Comprehensiveness and Coordination
Physicians participating in this new program will be paid incentive payments for specific quality and utilization metrics. These payments will either be kept by the physicians or will have to be repaid depending on performance in the metrics. The new model also focuses on ensuring the availability of electronic health information.
On August 1st, CMS announced it would partner with the following 14 regions:
? Arkansas: Statewide
? Colorado: Statewide
? Hawaii: Statewide
? Kansas and Missouri: Greater Kansas City Region
? Michigan: Statewide
? Montana: Statewide
? New Jersey: Statewide
? New York: North Hudson-Capital Region
? Ohio: Statewide and Northern Kentucky: Ohio and Northern Kentucky Region
? Oklahoma: Statewide
? Oregon: Statewide
? Pennsylvania: Greater Philadelphia Region
? Rhode Island: Statewide
? Tennessee: Statewide
CMS began soliciting applications from practices within the 14 regions beginning August 1, 2016. The application submission deadline is September 15, 2016. Practices will only be eligible to apply to CPC+ if they are located in one of the 14 selected CPC+ regions. This ensures that they are provided adequate support from multiple payers in their area and improve the success of the new delivery system.