Cooperating for better care.

Comprehensive Primary Care Plus

Tag Archives

Change in CMS primary-care program seen scaring away some providers

February 22, 2017by Robert Whitcomb in Uncategorized tagged , , , ,

The Centers for Medicare & Medicaid Services wants to expand the  model called Comprehensive Primary Care Plus. But an adjustment in how some providers are reimbursed in it could discourage providers from joining, reports Modern Healthcare.

The agency will gather providers into two groups, with “one receiving CPC Plus payments such as care-management fees, performance-based incentive payments or comprehensive primary-care payments, while the other will not,” reported the publication.Paul Ginsburg, a professor of health policy and management at the University of Southern California,  told Modern Healthcare  that the change would make federal attempts to evaluate CPC Plus stronger, but will lead to less participation.

“And there are questions about whether the randomized version of CPC Plus will still count as an alternative pay model under the Medicare Access and CHIP Reauthorization Act.” the publication reported.

Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association, that would be a huge disincentive to providers.

Still, the struggle to win providers could be less to do with CPC Plus itself, and more with the information overload of alternative pay models in recent years, David Introcaso, AMGA’s senior director of regulatory and public policy, told Modern Healthcare.

To read the article, please hit this link.

CMS widens options for APMs

October 25, 2016by Robert Whitcomb in Uncategorized tagged , , , , , ,

CMS  offering additional opportunities for physicians and other clinicians to join advanced Alternative Payment Models beginning in 2017 and 2018.

The advanced Alternative Payment Model is the more lucrative of two options under the Medicare Access and CHIP Reauthorization Act, (MACRA) a payment system for Medicare physician fees that replaces the controversial Sustainable Growth Rate formula.

CMS will offer the Oncology Care Model with two-sided risk as a qualifying advanced APM beginning in 2017 and  will reopen applications for the Comprehensive Primary Care Plus model and the Next Generation ACO model for the 2018 performance year.

Patrick Conway, M.D., deputy CMS Administrator,  said:

“With these new opportunities, CMS expects that by the 2018 performance period, 25 percent of clinicians in the Quality Payment Program will earn incentive payments by being a part of these advanced models. Thanks to MACRA and the Innovation Center, we’re striving to see more Medicare patients benefit from better care when they visit their doctor for a knee replacement, receive cancer treatment or have a coordinated care team manage their complex conditions.”

Physicians who participate in Medicare must submit at least some performance data next year to avoid a penalty under MACRA. These data will determine payment adjustments beginning in 2019. Physicians who qualify as an advanced APM will avoid some reporting requirements and be eligible for a 5 percent lump-sum bonus.

To read a Becker’s Hospital Review article on this, please hit this link.

How Minn. saves a pile with ‘healthcare homes’

April 14, 2016by Robert Whitcomb in Uncategorized tagged ,

 

Governing magazine looks at how  the Feds’ new Comprehensive Primary Care Plus program will affect how 20,000 doctors serve 25 million patients. The five-year program, which will be launched next January, will pay participating providers a fixed monthly fee, along with bonuses for meeting various health goals. Traditionally, those providers have been reimbursed based on the number of patient visits or procedures. “That approach has long been lambasted by healthcare experts as a big reason for rising costs,” the magazine noted.

The new move could encourage states to adopt the “healthcare home” model that’s been shown not only to improve health outcomes but also to save billions of dollars. Despite the potential,  states have not widely embraced it.

Governing looks at one state that has embraced it — Minnesota.

“The Land of 10,000 Lakes”  has become a model for healthcare homes,  a program that has saved it more than $1 billion over the past five years, said  a study by the University of Minnesota earlier this year. “These healthcare homes embody precisely what advocates of a coordinated healthcare system want: a one-stop shop for a patient to get all of her health needs met in as few visits as possible.”

One state that has become a model for health-care homes is Minnesota, which has saved more than $1 billion over the past five years by investing in that form of care, according to a study by the University of Minnesota earlier this year. These health-care homes embody precisely what advocates of a coordinated health-care system want: a one-stop shop for a patient to get all of her health needs met in as few visits as possible.

Contact Info

info@cmg625.com

(617) 230-4965

Wellesley, Mass