Led by the CMS Centers for Medicare and Medicaid Innovation (CMMI), the Comprehensive Primary Care initiative (CPC initiative) is a four-year, multi-payer initiative designed to test practice redesign models and a supportive multi-payer payment model.
Under the CPC initiative, CMS will pay selected primary care practices in seven geographic markets a care management fee (initially set at an average of $20 per beneficiary per month) to support enhanced, coordinated services for Medicare beneficiaries in addition to fee-for-service payments.
Simultaneously, participating commercial, state, and other federal insurance plans are offering enhanced payment to primary care practices designed to support them in providing high-quality primary care on behalf of their members. Selected practices may also receive shared savings payment in the later years of the initiative.
This was successfully posted to your pofile.
This box will close automatically in a few seconds. Close this window
We don't have an e-mail address on file for you. To use AAFP Connection, you must have an e-mail address in our records. Click Here
Comprehensive Primary Care Initiative
Risk-Stratified Care Management
Implementing the CPC Initiative
On October 1, 2012, the CPC initiative launched with participating practices in the Arkansas and Oklahoma (Greater Tulsa region) markets with the Oregon, Colorado, Ohio (Cincinnati-Dayton region and Northern Kentucky region), New Jersey, and New York (Hudson-Valley region) markets following on November 1, 2012. This included receipt of initial per member per month (PMPM) payments based on an attribution formula for qualified patients as well as participation in national and local learning collaboratives designed to assist practices in achieving practice redesign.
Five Comprehensive Primary Care Functions and Nine Key 1st Year Milestones
The framework for the CPC initiative set by CMS is designed to achieve the Institute for Health Improvement's Triple Aim of better health, better care, at lower costs.
CMS believes this can be achieved through the provision of comprehensive primary care, including Enhanced Accountable Payment, Continuous Improvement Driven by Data, Optimal Use of Health IT, and implementation of five Comprehensive Primary Care Functions:
CMS believes this can be achieved through the provision of comprehensive primary care, including Enhanced Accountable Payment, Continuous Improvement Driven by Data, Optimal Use of Health IT, and implementation of five Comprehensive Primary Care Functions:
- Risk-stratified care management
- Access and continuity
- Planned care for chronic conditions and preventive care
- Patient and caregiver engagement
- Coordination of care across the medical neighborhood
CMS also created Nine Key 1st Year Milestones they believe will lead practices to successful practice redesign. See a complete list of the milestones in the FAQ. The first milestone on creating a budget forecast is due in February 2013. View the new PCMH budgeting and forecasting information, including a budget template.
The AAFP's Division of Practice Advancement is working to create and distribute resources and tools during the four-year initiative to assist participating family physicians in achieving the practice redesign requirements set forth by CMS. AAFP resources and tools are designed as general guidance to compliment materials created by CMS. The AAFP's patient-centered medical home offers more information on comprehensive care.
Visit the Center for Medicare and Medicaid Innovation's website for further information on the CPC initiative.
The AAFP's Division of Practice Advancement is working to create and distribute resources and tools during the four-year initiative to assist participating family physicians in achieving the practice redesign requirements set forth by CMS. AAFP resources and tools are designed as general guidance to compliment materials created by CMS. The AAFP's patient-centered medical home offers more information on comprehensive care.
Visit the Center for Medicare and Medicaid Innovation's website for further information on the CPC initiative.
More Information on the CPC Initiative
CMS Announces Practices Chosen for the CPC Initiative -- Read the criteria CMS used to chose practices for the initiative.
Selected Payers in Seven CPC Initiative Markets -- On June 6, The CMS Innovation Center announced the list of 45 payers that signed memorandums of understanding to participate in the CPC initiative markets.
Questions about the CPC initiative? Read the FAQ.
Access TransforMED and Delta-Exchange for a wide range of transformation services, including webinars, practice facilitation, and social media sharing with colleagues.
Read more about the CPC initiative in Family Practice Management: The Comprehensive Primary Care Initiative: What You Need to Know.
Learn more about comprehensive care with the AAFP’s patient-centered medical home resources.
Additionally, further information on the CPC initiative is made available on the Center for Medicare and Medicaid Innovation's web page.
Selected Payers in Seven CPC Initiative Markets -- On June 6, The CMS Innovation Center announced the list of 45 payers that signed memorandums of understanding to participate in the CPC initiative markets.
Questions about the CPC initiative? Read the FAQ.
Access TransforMED and Delta-Exchange for a wide range of transformation services, including webinars, practice facilitation, and social media sharing with colleagues.
Read more about the CPC initiative in Family Practice Management: The Comprehensive Primary Care Initiative: What You Need to Know.
Learn more about comprehensive care with the AAFP’s patient-centered medical home resources.
Additionally, further information on the CPC initiative is made available on the Center for Medicare and Medicaid Innovation's web page.
