The CMS announced The Comprehensive Primary Care Plus initiative on Monday that plans to transform the delivery and reimbursement for primary care in the United States. In the initiative, the CMS will pay a monthly fee to practices to manage about 25 million patients.
A Look at the Numbers
- The initiative will be implemented in up to 20 regions
- The initiative will include up to 5,000 practices
- More than 20,000 doctors and clinicians will be affected
Providers will have two different track options for participating in the initiative. Track 1 will provide the option for provider practices that provide specific services will receive a monthly payment from the CMS as well as the fee-for-service payments. Track 2 has a different option, where provider practices will receive the monthly payment, but will receive a reduced Medicare fee-for-service payment and up-front comprehensive primary-care payments instead for the Medicare fee-for-service payments for evaluation and management services.
Provider practices in both tracks will receive an additional incentive payment to provide quality service. If practices do not perform well based on quality and utilization metrics, they may have to repay back the incentive payments.
The CMS will start soliciting payer proposals on April 12 to see which insurers are interested in participating as a partner and to get an idea of the regions. Then from those interested regions, the CMS will solicit from nearby practices between July 15 and September 1.
Read the original article from Modern Healthcare here.
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