The Center for Medicare & Medicaid Innovation has released the application for primary care practices in 8 states, including Oregon, to participate in a four-year Comprehensive Primary Care (CPC) initiative to test a new healthcare delivery and payment model based on high quality, patient-centered and coordinated primary care. Under the CPC Initiative, CMS will pay a non-visit care management fee of approximately $20 per beneficiary per month. At the same time, participating commercial, state, and other federal insurers will pitch in some additional payment. The increased payment opportunity will offer a measure of financial support to practices that provide comprehensive, coordinated care services, such as expanded clinic hours, planned care for chronic conditions and preventative care, and nutrition and/or smoking cessation counseling. In addition, there is the potential to share in any savings to the Medicare program.
The CPC Initiative is limited to physician practices that generate most of their revenue from Medicare and the other participating payers. In Oregon, this includes CareOregon, ODS Health Plan, Oregon Health Authority, Providence Health Plans, Teamsters Multi-Employer Taft Hartley Funds and Tuality Health Alliance. The total number of practices chosen will be limited to 75 clinics who:
• Treat at least 150 Medicare patients
• Generate at least 60% of revenue from the payers participating in the initiative
• Have achieved or are in the process of achieving Stage 1 Meaningful Use of an electronic health record system
• Have started transforming their practice model to obtain a state-based medical home designation or have completed a national recognition program
• Have participated in practice transformation activities during the past 3 years
The first step in applying for the program is to complete a practice pre-screen tool which can be found online at the Innovation Center’s website: https://cmsgov.secure.force.com/cpci/cpciscreening. The application deadline is July 20, 2012.