A select group of primary care practices will receive financial incentives to support enhanced, coordinated services on behalf of Medicare fee-for-service beneficiaries, the Centers for Medicare & Medicaid Services announced Wednesday.
Some 500 primary care practices in eight states have been chosen by CMS to participate in a four-year pilot called the Comprehensive Primary Care Initiative (CPCI).
The 2,100 individual providers will receive payment from both government and commercial payers to deliver care to more than 300,000 Medicare fee-for-service beneficiaries.
CMS will pay a management fee that will average $15 to $20 per beneficiary per month. Other government and commercial payers will offer enhanced payments to the primary care practices. After two years providers will have a chance to share in any savings they generate.
The additional monies may be used to help physicians cover the costs of extended treatment hours, electronic health records, coordinating care with other healthcare providers, engaging patients in managing their own care, as well as providing individualized care for patients living with multiple chronic diseases.
Practices were selected through a competitive application process based on their use of health information technology, ability to demonstrate recognition of advanced primary care delivery by accreditation bodies, service to patients covered by participating payers, participation in practice transformation and improvement activities, and diversity of geography, practice size and ownership structure.
The selection process began late in 2011 when CMS recruited a pool of commercial and state payers to the CPCI program.
Some 40 public and private payers in Arkansas, Colorado, Kentucky, New Jersey, New York, Ohio, Oklahoma, and Oregon joined the program. The seven pilot locations were designated based on the percentage of the total population covered by the participating payers.
The number of beneficiaries in each pilot ranges from 40,500 in the Capital District-Hudson Valley Region of New York to 51,000 in Arkansas. Participating payers include Anthem Blue Cross Blue Shield of Colorado, Cigna, Humana, and UnitedHealthcare.
"Primary care practices play a vital role in our health care system and we are looking at ways to better support them in their efforts to coordinate care for their patients," Marilyn Tavenner, the acting CMS administrator, said in a press release.
Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
