If you are primary care and are in the chosen states check out CPC+. Significant financial incentive for basically PCMH on steroids. My practice and region have been participating in the forerunner CPCI with great satisfaction, better outcomes, and better value for all.

AC has provided a global Track 2 support letter on the CMS website. So any AC primary care provider in the targeted regions have a relatively clear path to apply.

Larry
Solo IM
Cincinnati OH



>>>> from CMS website


Comprehensive Primary Care Plus

Comprehensive Primary Care Plus (CPC+) is a national advanced primary care medical home model that aims to strengthen primary care through a regionally-based multi-payer payment reform and care delivery transformation. CPC+ will include 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 (U.S.). The care delivery redesign ensures practices in each track have the infrastructure to deliver better care to result in a healthier patient population. The multi-payer payment redesign will give practices greater financial resources and flexibility to make appropriate investments to improve the quality and efficiency of care, and reduce unnecessary health care utilization. CPC+ will provide practices with a robust learning system, as well as actionable patient-level cost and utilization data feedback, to guide their decision making.

CPC+ is a five-year model that will begin in January 2017.

Background

Strengthening primary care is critical to promoting health and reducing overall health care costs in the U.S. CPC+ builds on the foundation of the Comprehensive Primary Care (CPC) initiative, a model tested through the Center for Medicare & Medicaid Innovation that runs from October 2012 through December 31, 2016. CPC+ integrates many lessons learned from CPC, including insights on practice readiness, the progression of care delivery redesign, actionable performance-based incentives, necessary health information technology, and claims data sharing with practices.

CPC+ will bring together CMS, commercial insurance plans, and State Medicaid agencies to provide the financial support necessary for practices to make fundamental changes in their care delivery. CMS will enter into a Memorandum of Understanding (MOU) with selected payer partners to document a shared commitment to align on payment, data sharing, and quality metrics throughout the five year initiative.
Model Details

The goal of CPC+ is to improve the quality of care patients receive, improve patients? health, and spend health care dollars more wisely. 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. Additional information about each CPC+ region and payer (PDF) is now available and listed below:

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

To support the delivery of comprehensive primary care, CPC+ includes three payment elements:

Care Management Fee (CMF): Both tracks provide a non-visit based CMF paid PBPM. The amount is risk-adjusted for each practice to account for the intensity of care management services required for the practice?s specific population. The Medicare FFS CMFs will be paid to the practice on a quarterly basis.
Performance-based incentive payment: CPC+ will prospectively pay and retrospectively reconcile a performance-based incentive based on how well the practice performs on patient experience measures, clinical quality measures, and utilization measures that drive total cost of care.
Payment under the Medicare Physician Fee Schedule: Track 1 continues to bill and receive payment from Medicare FFS as usual. Track 2 practices also continue to bill as usual, but the FFS payment will be reduced to account for CMS shifting a portion of Medicare FFS payments into Comprehensive Primary Care Payments (CPCP), which will be paid in a lump sum on a quarterly basis absent a claim. Given our expectations that Track 2 practices will increase the comprehensiveness of care delivered, the CPCP amounts will be larger than the FFS payment amounts they are intended to replace.

CPC+ Financial Summary Table
Track
Care Management Fees, PBPM
Performance-Based Incentive Payments
Visit and Non-Visit Based Payments

1
$15 average
Utilization and Quality/Experience Components
CMF + FFS

2 $28 average; $100 for complex Utilization and Quality/Experience Components CMF + ↓ FFS + ↑ CPCP


How to Apply

CMS solicited payer proposals to partner with Medicare in CPC+ (April 15-June 8, 2016). 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.

Eligible practices within these 14 regions may apply to participate in CPC+ from August 1 ? September 15, 2016.

Practices applying to Track 2 will need to submit a letter of support from their Health IT vendor(s) that outlines vendors? commitment to supporting the practice with advanced health IT capabilities. CMS will sign a Memorandum of Understanding with those 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 8:30a.m. ? 7:30p.m. EDT at 1-844-442-2672.



Larry
Solo IM
Midwest