Comprehensive Primary Care Plus

CMS Selects Four New Regions to Expand CPC+ Initiative

May 23, 2017 12:14 pm News Staff

CMS recently announced four new regions(www.cms.gov) of the country where primary care practices will have an opportunity to apply to participate in the second round of the agency's Comprehensive Primary Care Plus (CPC+)(innovation.cms.gov) initiative.

[Pen writing the words Apply Now]

The new regions -- chosen based on payment alignment and market densities sufficient to ensure payer support for necessary practice changes -- are

  • Louisiana,
  • Nebraska,
  • North Dakota and
  • New York's greater Buffalo region (Erie and Niagara counties).

CMS intends to select as many as 1,000 practices across the four regions.

Physicians interested in this opportunity should act quickly to apply(app1.innovation.cms.gov) because the application window opened on May 18 and runs only through July 13.

Family physicians may remember that CMS launched the first round of CPC+ on Jan. 1, 2017, in 14 regions with 53 payers and 2,891 practices. It's important to note that practices in regions chosen for round one are not eligible to apply for CPC+ round two.

According to an AAFP FAQ, participation in CPC+ is available only to primary care practices -- defined as family medicine, internal medicine and geriatric medicine practices -- of any size.

The AAFP offers more background to help family physicians decide if CPC+ round two sounds like a challenge they are ready to take on.

For example, eligible practices must, among other things,

  • have at least 125 attributed Medicare Part B fee-for-service beneficiaries (excluding patients with Medicare Advantage plans),
  • use certified electronic health record technology, and
  • utilize care delivery activities that include 24-hour-a-day access for patients and support for quality improvement activities.

Note that practices that charge a retainer or practice membership fee -- typically direct primary care practices -- are not eligible to apply for this initiative.

On the application form, practices must choose one of two tracks. According to CMS, track one "is intended for practices that have the health information technology and other basic infrastructure necessary to delivery comprehensive primary care."

Track two is designed for practices already proficient in comprehensive primary care who want to increase the "depth, breadth and scope of medical care delivery to their patients," especially those with complex health care needs.

Regardless of which track they choose, practices must provide patient-centered care that includes access and continuity; care management; comprehensiveness and coordination; patient and caregiver engagement; and planned care, including population health.

In return, CMS provides prospective monthly care management fees to practices in both tracks.

"Payment redesign offers the ability for greater cash flow and flexibility for primary care practices to deliver high-quality, patient-centered care and lower the use of unnecessary services that drive total costs of care," says the CMS announcement.

Furthermore, "CPC+ will provide practices with a robust learning system, as well as actionable patient-level cost and utilization data, to guide their decision-making."

Review the CMS FAQ(innovation.cms.gov) for additional requirements and payment information.

Is your interest sufficiently piqued?

Contact the AAFP with your questions; staff members stand ready to provide answers and help you assess whether CPC+ is a good fit for your practice.

Related AAFP News Coverage
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CMS Announces New Advanced Payment Model Opportunities

(11/16/2016)

Heads Up: Time to Apply for CPC+ Initiative
CMS Selects 14 Regions Across Country

(8/3/2016)

AAFP Collaborates With Caravan Health on CPC+ Readiness
Free Summer Boot Camp Now in Session

(6/30/2016)