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Comprehensive Primary Care Initiative
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.
Risk-Stratified Care Management
Implementing the CPC Initiative
Five Comprehensive Primary Care Functions and Nine Key 1st Year Milestones
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
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
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.