By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    benefits of using protein powder to build muscles
    Protein Powder for Muscle Mass: Everything You Need to Know
    December 12, 2021
    changes brought on by blockchain in healthcare
    Technology In The Healthcare Industry
    March 28, 2022
    What Does Core Body Temperature Say About Health?
    August 17, 2022
    Latest News
    Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
    May 16, 2025
    Learn how to Renew your Medical Card in West Virginia
    May 16, 2025
    Choosing the Right Supplement Manufacturer for Your Brand
    May 1, 2025
    Engineering Temporary Hospitals for Extreme Weather
    April 24, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Media Begin Focus on Next Iteration of ACA
    December 13, 2012
    chronic pain
    Invisible Illness Insights: “A Little Understanding Could Change So Many Lives”
    November 18, 2014
    Do Electronic Health Records Reduce Malpractice Claims?
    February 2, 2013
    Latest News
    Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
    May 18, 2025
    The Critical Role of Healthcare in Personal Injury Recovery: A Comprehensive Guide for Victims
    May 14, 2025
    The Backbone of Successful Trials: Clinical Data Management
    April 28, 2025
    Advancing Your Healthcare Career through Education and Specialization
    April 16, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Comprehensive Primary Care Plus – Medicare Doubles Down
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > Health Reform > Comprehensive Primary Care Plus – Medicare Doubles Down
Health Reform

Comprehensive Primary Care Plus – Medicare Doubles Down

David Harlow
Last updated: April 30, 2016 12:00 pm
David Harlow
Share
5 Min Read
playing-cards
SHARE
playing-cards

CMS, through its Centers for Medicare and Medicaid Innovation (CMMI), is rolling out a refined version of an innovation model that is just winding down its four-year run.

playing-cards

CMS, through its Centers for Medicare and Medicaid Innovation (CMMI), is rolling out a refined version of an innovation model that is just winding down its four-year run. Per CMMI, the Comprehensive Primary Care (CPC) initiative

is a four-year multi-payer initiative designed to strengthen primary care. Since CPC’s launch in October 2012, CMS has collaborated with commercial and State health insurance plans in seven U.S. regions to offer population-based care management fees and shared savings opportunities to participating primary care practices to support the provision of a core set of five “Comprehensive” primary care functions. These five functions are: (1) Risk-stratified Care Management; (2) Access and Continuity; (3) Planned Care for Chronic Conditions and Preventive Care; (4) Patient and Caregiver Engagement; (5) Coordination of Care across the Medical Neighborhood. The initiative is testing whether provision of these functions at each practice site — supported by multi-payer payment reform, the continuous use of data to guide improvement, and meaningful use of health information technology — can achieve improved care, better health for populations, and lower costs, and can inform future Medicare and Medicaid policy.

Comprehensive Primary Care Plus (CPC+) is slated to go live January 2017. (CPC+ presser, CPC+ RFA, summary of CPC+ IT requirements). Per CMMI,

the five-year CPC+ model will benefit patients by helping primary care practices:

  • Support patients with serious or chronic diseases to achieve their health goals
  • Give patients 24-hour access to care and health information
  • Deliver preventive care
  • Engage patients and their families in their own care
  • Work together with hospitals and other clinicians, including specialists, to provide better coordinated care

Primary care practices will participate in one of two tracks. Both tracks will require practices to perform the functions and meet the criteria listed above, but practices in Track 2 will also provide more comprehensive services for patients with complex medical and behavioral health needs, including, as appropriate, a systematic assessment of their psychosocial needs and an inventory of resources and supports to meet those needs.

CPC+ will help practices move away from one-size-fits-all, fee-for-service health care to a new system that will give doctors the freedom to deliver the care that best meets the needs of their patients. In Track 1, CMS will pay practices a monthly care management fee in addition to the fee-for-service payments under the Medicare Physician Fee Schedule for activities. In Track 2, practices will also receive a monthly care management fee and, instead of full Medicare fee-for-service payments for Evaluation and Management services, will receive a hybrid of reduced Medicare fee-for-service payments and up-front comprehensive primary care payments for those services. This hybrid payment design will allow greater flexibility in how practices deliver care outside of the traditional face-to-face encounter.

A recently published study of the CPC model showed that, after two years, CMS got (statistically speaking) zero bang for its buck. (Follow the link above to Jaan Sidorov’s post about the study and the model on the Population Health Blog; he discussed it with Joe Paduda and me as part of a recent Health Wonk Review on Air Blab).

More Read

Blurred Lines: Angling for Advantage in the “New Normal” of the ACA
Health Care’s Anti-Cash Bias
Patients’ Health Data Rights and Precision Medicine
Where the US Lags Italy in Healthcare
Pennsylvania House of Representatives Passes Medical Marijuana Bill

I’ll be discussing the CPC+ model on today’s #hcbiz Tweetchat and Blab with co-hosts Don Lee and Shahid Shah, and PCPCC President Marci Nielsen. Join us live at 12 noon ET on Twitter and at 12:30 on Blab (both accessible via the link live and as a replay).

David Harlow
The Harlow Group LLC
Health Care Law and Consulting

             

Related Stories

  • Health Wonk Review is Up – Join Health Wonks on Blab

 

You should follow me on Twitter: @healthblawg
             
 

 

TAGGED:Centers for Medicare and Medicaid Innovation
Share This Article
Facebook Copy Link Print
Share
By David Harlow
Follow:
DAVID HARLOW is Principal of The Harlow Group LLC, a health care law and consulting firm based in the Hub of the Universe, Boston, MA. His thirty years’ experience in the public and private sectors affords him a unique perspective on legal, policy and business issues facing the health care community. David is adept at assisting clients in developing new paradigms for their business organizations, relationships and processes so as to maximize the realization of organizational goals in a highly regulated environment, in realms ranging from health data privacy and security to digital health strategy to physician-hospital relationships to the avoidance of fraud and abuse. He's been called "an expert on HIPAA and other health-related law issues [who] knows more than virtually anyone on those topics.” (Forbes.com.) His award-winning blog, HealthBlawg, is highly regarded in both the legal and health policy blogging worlds. David is a charter member of the external Advisory Board of the Mayo Clinic Social Media Network and has served as the Public Policy Chair of the Society for Participatory Medicine, on the Health Law Section Council of the Massachusetts Bar Association and on the Advisory Board of FierceHealthIT. He speaks regularly before health care and legal industry groups on business, policy and legal matters. You should follow him on Twitter.

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

Clinical Expertise
Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
Health care
May 18, 2025
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Health
May 15, 2025
Learn how to Renew your Medical Card in West Virginia
Learn how to Renew your Medical Card in West Virginia
Health
May 15, 2025
Dr. Klaus Rentrop Shares Acute Myocardial Infarction heart treatment
Dr. Klaus Rentrop Shares Acute Myocardial Infarction
Cardiology
May 13, 2025

You Might also Like

GOP health plan
Health ReformPolicy & Law

GOP Health Plan: Good, Bad and Ugly

September 23, 2013
health_collective_ACA
BusinessFinanceHealth ReformPolicy & Law

Actuarial Study Results a Mixed Bag on Costs of Claims under ACA

March 28, 2013
biopharmaceuticals
BusinessFinanceHealth ReformHospital AdministrationMedical InnovationsPublic Health

The Price, Cost, and Value of Bio-Pharmaceutical Care

October 3, 2013
Health Reform

Meaningful Use Criteria and the ACO

September 28, 2011
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?