Comments on Multipayer PCMH Evaluation Demo Could Lead to Expanded Project

June 19, 2012 04:55 pm News Staff

CMS is seeking comments on an evaluation process for a multipayer demonstration project that could determine whether the project is expanded and how it is expanded beyond the eight states where it currently operates.

The project, known as the Multi-Payer Advanced Primary Care Demonstration, relies on both public and private payers to compensate physicians and other providers for delivering coordinated care through patient-centered medical homes (PCMH) in Maine, Michigan, Minnesota, New York, North Carolina, Pennsylvania, Rhode Island and Vermont. Launched in 2009, the project pays participating medical home practices via a combination of Medicare, Medicaid and private health plans.

CMS currently is assessing the effectiveness of the program, using both qualitative and quantitative data to determine whether the pilot project should be expanded beyond the eight states. The agency has published a notice(www.gpo.gov) in the Federal Register seeking public comments on how to better evaluate and revise its method of collecting information for the pilot project.

"The goal of evaluating and revising the CMS-855B enrollment application is to simplify and clarify the information collection without jeopardizing our need to collect specific information," says the Federal Register notice.

The information gathered by CMS will help the agency determine whether the pilot "should be expanded under Medicare and if so, what modifications and supports would be needed to implement similar innovations in other states and practices in the future."

Evaluation data for the current demonstration project are designed to gauge "the effects of advanced primary care practice when supported by Medicare, Medicaid and private health plans," according to CMS. And the evaluation itself is studying various features of the multi-payer project, such as payment models, PCMH transformation and outcomes data that address access to care, care coordination, beneficiary experience, and Medicare and Medicaid expenditures.

The date for submitting comments to CMS is July 30. Comments can be submitted electronically(www.regulations.gov) or by mail to CMS, Office of Strategic Operations and Regulatory Affairs, Division of Regulations Development, Room C4-26-05, 7500 Security Blvd., Baltimore, MD, 21244-1850.


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