This month, the Centers for Medicare & Medicaid Services (CMS) opened the application period for practices to participate in the new primary care model, Comprehensive Primary Care Plus (CPC+), which is available to practices in Kansas and Missouri. This model is an important opportunity to increase access and comprehensiveness of care to patients in rural communities. The CPC+ practice application period runs from August 1 – September 15, 2016.
CPC+ offers a unique chance for eligible primary care practices in 14 regions and states across the country to receive additional financial and technical support from Medicare and other payers. Across these 14 regions, CMS’ goal is to have a large geographic spread and to ensure that rural practices are well represented in CPC+. In addition to the added support practices will receive from Medicare in CPC+, some may also be eligible for a 5% bonus payment for participating in an Advanced Alternative Payment Model through the proposed CMS Quality Payment Program.
CPC+ is a five-year primary care medical home model beginning January 2017. The goal of CPC+ is to give primary care practices more flexibility in caring for their patients in the way they think will deliver the best outcomes and to pay them for achieving results and improving care. Additionally, other payers, including commercial insurers and state Medicaid agencies, are partnering with CMS to provide enhanced support to the primary care practices selected to participate in CPC+. CMS will accept up to 5,000 primary care practices serving up to an estimated 3.5 million Medicare beneficiaries and up to approximately 25 million patients overall.
Please note that at this time rural health centers (RHCs) and federally qualified health centers (FQHCs) are not eligible to participate in CPC+ because they do not submit claims on a Medicare Physician/Supplier claim form (CMS 1500) and are not paid according to the Medicare Physician Fee schedule for office visits.
We have an array of information available on the CPC+ website. Materials targeted to your members include:
- Schedule of open door forums held during the practice application period
- A one-page overview of the program
- Short videos explaining payment innovations and care delivery requirements
- Slide presentation that provides an overview of CPC+
- Reflections from participants in the current CPC model
General questions about CPC+ can be submitted to CPCplus@cms.hhs.gov.