Selected Payers and Markets for 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. Each market is multi-payer and may include commercial, federal and State insurers. The CPC Initiative is a four year, multi-payer initiative led by the CMS Innovation Center designed to test a service delivery model of comprehensive and accountable primary care. The initiative includes a monthly, per-patient care management fee and the potential to share in any savings to the Medicare program, in addition to traditional fee-for-service payments.

Arkansas

Statewide (4 Payers):

  • Arkansas Blue Cross and Blue Shield
  • Arkansas Medicaid
  • Humana
  • QualChoice of Arkansas

Colorado

Statewide (9 Payers):

  • Anthem Blue Cross Blue Shield of Colorado
  • Cigna
  • Colorado Access
  • Colorado Choice Health Plans
  • Colorado Medicaid
  • Humana
  • Rocky Mountain Health Plans
  • Teamsters Multi-Employer Taft Hartley Funds
  • UnitedHealthcare

New Jersey

Statewide (5 Payers):

  • Amerigroup
  • AmeriHealth New Jersey
  • Horizon Blue Cross Blue Shield of New Jersey
  • Teamsters Multi-Employer Taft Hartley Funds
  • UnitedHealthcare

New York

Capital District-Hudson Valley Region (6 Payers):

  • Aetna
  • Capital District Physicians' Health Plan
  • Empire Blue Cross
  • Hudson Health Plan
  • MVP Health Care
  • Teamsters Multi-Employer Taft Hartley Funds

Counties within this region include: Albany, Columbia, Duchess, Greene, Orange, Putnam, Rensselaer, Rockland, Schenectady, Sullivan, Ulster, Westchester

Ohio and Kentucky

Cincinnati-Dayton Region (10 Payers):

  • Aetna
  • Amerigroup (Ohio only)
  • Anthem Blue Cross Blue Shield of Ohio
  • Humana
  • United Healthcare
  • CareSource (Ohio only)
  • HealthSpan
  • Medical Mutual
  • Centene Corporation (Ohio only)
  • Wellpoint
  • Ohio Medicaid within the Ohio Department of Job and Family Services

Counties within this region include the Ohio counties of Adams, Brown, Butler, Champaign, Clark, Clermont, Clinton, Greene, Hamilton, Highland, Miami, Montgomery, Preble, Warren and the Kentucky counties of Boone, Campbell, Grant, Kenton

Oklahoma

Greater Tulsa Region (3 Payers):

  • Blue Cross and Blue Shield of Oklahoma
  • CommunityCare
  • Oklahoma Health Care Authority

Counties within this region include: Adair, Atoka, Cherokee, Craig, Creek, Delaware, Hughes, Lincoln, Mayes, McIntosh, Muskogee, Noble, Nowata, Okfuskee, Okmulgee, Osage, Pawnee, Payne, Pittsburg, Pushmataha, Rogers, Sequoyah, Tulsa, Wagoner, Washington

Oregon

Statewide (7 Payers):

  • CareOregon
  • ODS Health Plan
  • Oregon Health Authority
  • Providence Health Plans
  • Regence Blue Cross Blue Shield of Oregon
  • Teamsters Multi-Employer Taft Hartley Funds
  • Tuality Health Alliance