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Thursday Mar 18, 2021

Primary Care First alternative payment model applications open, deadline in April

The Center for Medicare & Medicaid Innovation (CMMI) has released its Request for Applications (RFA) for Cohort 2(innovation.cms.gov) of the Primary Care First (PCF) model. Applications are due April 30, 2021.

The PCF model offers a multi-payer system for practices ready to take on more risk through payments based on utilization and outcomes. CMMI is accepting applications from all practices that meet the eligibility criteria in 26 regions, including practices currently participating in the Comprehensive Primary Care Plus (CPC+) model. PCF Cohort 2 will begin in January 2022 and run through 2026.

The PCF general model moves primary care clinicians from traditional fee-for-service payments to prospective payments with a potential performance bonus. Practices accepted into the program receive three types of payments:

  1. The total primary care payment. A risk-adjusted, population-based payment (ranging from $28 to $175 per-beneficiary, per-month, based on average panel risk) plus a flat visit fee ( of about $40) for each face-to-face primary care visit.
  2. A quarterly performance-based adjustment. Based on five quality measures and acute hospital utilization, this payment adjustment applies to total primary care revenue and ranges from a cut of 10% to a bonus of up to 50%.
  3. Standard fee-for-service payments. These are made for services provided other than those covered by the flat visit fee, such as procedures and vaccines.

CMMI is hosting two upcoming webinars for those interested in applying (all times are Eastern):

Additional information, including the American Academy of Family Physicians (AAFP) PCF Dashboard and Practice Assessment Checklist, can be found here:

—    Kate Freeman, Care Delivery and Payment Strategist at the AAFP

Posted at 11:45PM Mar 18, 2021 by Kate Freeman

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