Private Practices, Payers, and Health IT Vendors Partner Together for CMS's Innovative CPC+ Program


CMS just announced the innovative Comprehensive Primary Care Plus Program. This new five year program offers a unique way for primary care practices, payers, and health IT vendors to partner together to provide better care, smarter spending, and healthier people.

For primary care practices, CMS will offer two possible tracks (Track 1 and Track 2) that both focus on continuity of care, care management, and comprehensiveness and coordination of care for the patients. Track 1 is for practices ready to build their services and Track 2 is for practices ready to increase the comprehensiveness of their services.

Payment for services will move away from straight fee for service to a model based on quality of care, patient satisfaction, and outcomes. For practices that are selected into CPC+, they will receive a case management fee - ranging from $15 to $28 per beneficiary per month - regardless if the beneficiary has sought care that month. This incentive is offered to practices to offset the cost and support increased patient services such as 24/7 patient access, increased office hours, behavioral health integration, and E-visits.

CMS will select payer proposals from the applications submitted to partner with Medicare in CPC+ between now and June 1, 2016. There will be up to 20 CPC+ regions selected by the geographic reach of selected payers. Primary care practices will be selected between July 15, 2016 and September 1, 2016, and CMS will accept up to 2500 practices in each track.

Technology will play a major role in meeting the new initiative requirements and goals especially for those practices selected for Track 2. As a result, It is important to partner with vendors that are HiPAA and HiTech compliant for services such as video tele-conferencing and EMR’s. Track 2 requires that the health IT vendors provide a letter of intent during the application process and a Memorandum of Understating (MOU) with CMS once accepted into the program.  Be sure to select  health IT vendor(s) that are compliant with federal health care regulations, as this important collaboration with the IT vender(s) could affect your eligibility for selection in then CPC+ program!

For more information about CPC+ go to www.innovation.cms.gov/initiatives/comprehensive-primary-care-plus

Submitted by Dr. Martha Ireland

Co-Founder  VTConnect Enterprise solution for secure Video-teleconferencing services and admistrative web-portal. www.VTConnect.net