On September 28, 2011, the Centers for Medicare and Medicaid Services (CMS) Innovation Center launched the Comprehensive Primary Care (CPC) initiative, a multi-payor initiative that seeks to help primary care practices deliver higher quality, better coordinated, and more patient-centered care. The voluntary initiative will begin as a demonstration project available in five to seven health care markets across the country.
The CPC initiative will test two models simultaneously: a service delivery model and a payment model. The service delivery model will test comprehensive primary care, which is characterized as having the following five functions: (1) risk-stratified care management; (2) access and continuity; (3) planned care for chronic conditions and preventative care; (4) patient and caregiver engagement; and (5) coordination of care across the medical neighborhood. The payment model includes a monthly care management fee paid to the selected primary care practices on behalf of their fee-for-service Medicare beneficiaries and, in years two through four of the initiative, the potential to share in any savings to the Medicare program. Primary care practices will also receive compensation from other payors participating in the initiative, including private insurance companies and other health plans. According to CMS, this “will allow [practices] to integrate multi-payer funding streams to strengthen their capacity to implement practice-wide quality improvement.”
Public and private health care payers interested in applying to the CPC initiative must submit a nonbinding letter of intent (LOI) and a completed Geographic Service Area Worksheet to CMS by November 15, 2011. The LOI must indicate the level and type of support for primary care practices being offered. Final applications must be received on or before January 17, 2012.
More information about eligibility criteria, LOI, application materials and deadlines, or more information about the CPC initiative generally is available by clicking here.