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HHS Introduces Coordinated Care Pilot for PCPs

Margaret Dick Tocknell, for HealthLeaders Media, September 29, 2011

The Department of Health and Human Services is recruiting private payers to participate in a Medicare shared savings pilot oriented to primary care physicians.

The goal is to align physician practices and health insurers to coordinate care for Medicare patients, including managing the care of high-risk patients; promoting easy access to care, delivering preventive care engaging patients.

The four-year Comprehensive Primary Care Initiative will provide participating PCPs with an enhanced payment to deliver higher quality, more coordinated, and patient-centered care. In the first year of the pilot the payment will average $20 per month, per beneficiary. Shared savings will kick in during years two through four.

 The program was announced on Wednesday by HHS Secretary Kathleen Sebelius. The initiative is the latest in a series of Affordable Care Act programs developed to achieve what is called the Triple Aim: Better care, better health, and lower costs.

Other programs promote the formation of accountable care organizations, the bundled payment initiative and the partnership for patients. There is about $10 billion in the ACA budget to finance these initiatives, but HHS said a specific budget for the new program hasn't been developed.

The pilot is an effort to create a partnership between Medicare and other payers to invest in a new primary care health delivery and payment model. "We've heard the message loud and clear that if we want to change the healthcare delivery system we need to support primary care," said Dr. Richard J. Gilfillan, M.D., acting director of the Innovation Center at the Centers for Medicaid & Medicare Services during the press call to announce the program.

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