Primary care practices in Louisiana, Nebraska, North Dakota and New York’s Erie and Niagara Counties can now apply to participate in the second round of CMS’s Comprehensive Primary Care Plus (CPC+) model.
Those applicants would join the 2,891 practices and 53 payors across 14 regions taking a part of the first round of the multi-payer primary care medical home model, which encourages Medicare, state Medicaid agencies and commercial insurers to join with primary care physicians to redesign their care delivery models. CMS has called it “the future of primary care” and said it is especially geared towards small, independent and rural practices and helping them overcome the challenges of transitioning to value-based care.
CMS expects around 1,000 practices in the four new regions to participate in the second round. Applications will be accepted through July 13, 2017, with the program running from 2018 through 2022. Practices in the first round’s regions which either didn’t apply or were rejected aren’t eligible for this second round.
Under the program, practices can select two different tracks. Track 1 practices will continue to receive Medicare fee-for-service (FFS) payments, while those in Track 2 will get a mix of FFS payment and a new CPC payment which CMS said “promotes flexibility in how practices deliver care traditionally provided face-to-face, and supports practices to increase the depth and breadth of primary care they deliver.”
All CPC participants will receive incentive payments based on patient experience, quality and utilization measurement performance, as well as prospective monthly care management fees ranging from $6 to $100 per beneficiary, depending on the amount of risk shared by the practice.
Additionally, CPC+ participants will be eligible for 5 percent bonus as an Advanced Alternative Payment Model under the Medicare Access and CHIP Reauthorization Act.