CMS announces new Primary Care delivery model

Public and private payers can apply through June 1 to participate in a new medical home model that will build on the Comprehensive Primary Care model to help practices support patients with serious or chronic diseases, the Centers for Medicare & Medicaid Services announced today.

Under the CPC+ model, CMS will partner with insurers and Medicaid agencies in up to 20 regions and up to 5,000 practices to provide monthly care management fees based on beneficiary risk tiers.  The model can accommodate up to 5,000 practices, 20,000 doctors and the 25 million people they serve.

Beginning July 15, CMS will solicit applications from primary care practices in the selected regions to participate in one of two tracks.

  • Track 1 practices will continue to receive Medicare fee-for-service payments, while
  • Track 2 practices will receive a mixture of up-front CPC payment and reduced Medicare fee-for-service payment.

Track 2 practices must provide more comprehensive services for patients with complex medical and behavioral health needs and obtain a commitment from their health information technology vendors to support related health IT capabilities. Both tracks also will be eligible for performance-based incentive payments. For more on the five-year project, see the CMS factsheet.

The five-year CPC+ model will benefit patients by helping primary care practices:

  • Support patients with serious or chronic diseases to achieve their health goals
  • Give patients 24-hour access to care and health information
  • Deliver preventive care
  • Engage patients and their families in their own care
  • Work together with hospitals and other clinicians, including specialists, to provide better coordinated care