Clinics in Oregon that see at least 150 Fee-for-Service Medicare patients and are not an FQHC or RHC are encouraged to apply for the Comprehensive Primary Care Initiative (CPCi). Individual primary care practices located in Oregon may apply for the CPCi by 2:00 pm local time on Friday, July 20.
The Comprehensive Primary Care initiative is a multi-payer initiative fostering collaboration between public and private health care payers to strengthen primary care. Primary care practices that choose to participate in this initiative will be given resources to better coordinate primary care for their Medicare patients. The CPC initiative will test two models simultaneously: a new service delivery model and payment model of high value primary care. This model will support practices providing comprehensive services to patients on whose behalf they will receive enhanced payment from Medicare and other participating payers, which may include state Medicaid agencies and commercial health plans.
Participants in the initiative will receive $20 per member per month on all Medicare Fee-for-Service patients and between $2 and $40 per member per month on all patients with participating plans. For a clinic that sees 500 Medicare patients per year and has 5000 other patients eligible, this is around $500,000 per year in additional income.
You are encouraged to apply even if you are part of a CCO. The goals of the program align nicely with those of the CCOs and provide initial incentives directly into primary care.
How to apply
To apply for the Comprehensive Primary Care Initiative, submit an application, available at https://cmsgov.secure.force.com/cpcipa, by Friday, July 20, 2012 at 2:00 pm.
To understand if you qualify, you will need to pull revenue data for CY2011 for the participating payers (given in the application) and determine if they represent roughly 60 percent of your revenue; anyone who is close should apply. You will also need to generate a report to count patients seen in CY2011 by payer and by demographic information. The rest of the application is brief information about your clinic.
Free webinars will answer your CPCi questions
CMS will host free webinars to provide more information about the initiative and answer your practice's questions:
- Everything You Wanted to Know to Apply to the CPC initiative
Hosted by CMS
July 12, 2012 at 4:00 pm - Click here to access the webinar (no registration necessary) - Everything You Wanted to Know to Apply to the CPC initiative
Hosted by CMS
July 16, 2012 at 4:00 pm - Click here to access the webinar (no registration necessary)
If you are unable to take part in these webinars or would like more information, visit the CMS Innovation Center's CPCi website at www.innovation.cms.gov/initiatives/Comprehensive-Primary-Care-Initiative/index.html. If you have any questions, contact CPCi@cms.hhs.gov.