Arkansas health care providers won’t want to miss a great opportunity to improve their Medicare patients’ outcomes, while gaining greater financial resources and more flexibility to improve the quality and efficiency of the care they provide.
The new opportunity, called CPC+ (Comprehensive Primary Care Plus), is the next step in the Centers for Medicare and Medicaid Services’ (CMS) very successful initiative that is moving the nation to a value-based payment system for Medicare services. CMS has chosen the entire state of Arkansas to participate in CPC+.
Building on the patient-centered medical home (PCMH) model, CMS implemented CPC classic in seven regions across the nation that served 2,188 participating providers in 441 CPC practice sites. In Arkansas, 230 primary care providers in 58 practices across the state worked with CPC classic. After four successful years, CPC classic will end on Dec. 31. CPC+ will continue this initiative and further strengthen and support primary care providers (PCPs). Strong primary care is an essential component in controlling the nation’s health care costs.
CPC+’s sign-up deadline for providers is Sept. 15, 2016. The five-year program will begin in Jan. 2017.
If a practice chooses to enroll in CPC+, it will select one of two tracks. Track 1 is for providers who are just beginning to transform their practices to support patients with complex needs. Track 2 is for providers who are further along in the transformation process and who can provide more comprehensive care, especially for patients with chronic conditions.
CPC+ includes three types of payments:
- Both tracks will continue to bill and receive payments from Medicare fee-for-service (FFS). For track 2 providers, CMS will shift a portion of the usual Medicare FFS payments into Comprehensive Primary Care Payments (CPCP). Because Track 2 providers will provide more comprehensive care, the CPCP amounts will be larger than the FFS payments they will replace.
- Care management fees are available if practices provide specific services. The fees will be risk-adjusted to account for the intensity of care management required for your specific population. Both tracks can receive these fees and all providers, public and commercial, will make these payments.
- Performance-based incentives – paid prospectively and reconciled retrospectively – are based on how well the practice performs on measures that drive the total cost of care. Practices must be able to show improvements in patient outcomes and quality of care.
Practices applying to Track 2 will need to submit a letter of support from their Health IT vendor(s) that outlines the vendors’ commitment to supporting the practice with advanced health IT capabilities. CMS will sign a Memorandum of Understanding with the health IT vendors supporting Track 2 practices selected to participate in CPC+.
For questions about the model or the solicitation process, please email CPCplus@cms.hhs.gov or call the CPC+ Help Desk from 8:30 a.m.-7:30 p.m. EDT at 1-844-442-2672.
Sign up for CPC+ by Sept. 15 at the CPC+ Online Application Portal HERE.