In April we published a post announcing the launch of the new risk-based primary care initiative, Comprehensive Primary Care Plus (CPC+). Now, we are nearly just one week away from applications for CPC+ being due. So what should you know before submitting your application? We've compiled a list of frequently asked questions about the CPC+ program and some answers to help you better understand it.
Understanding the Two Paths to the MACRA Legislation
Before we go further into the Comprehensive Primary Care Plus program, I want to make sure I touch on how the CPC+ program fits into the MACRA legislation.
As many of us now know there are two paths to the MACRA legislation. One is the Merit-based Incentive Payment System (MIPS) path and the other is the Advanced Alternative Payment Models (APMs) path.
In order to participate in the APMs path clinicians must prove “significant” participation in an Advanced Alternative Payment Model. In doing so, those clinicians will be:
In this article, we’ll discuss one of the six Alternative Payment Models that have been deemed an Advanced APM by CMS for the first performance year of 2017; the Comprehensive Primary Care Plus (CPC+) payment model.
The enrollment period began on August 1, 2016 and will end on September 15, 2016. Click here to visit the CMS portal to submit your application today.
CPC+ is a CMS program that is a new medical home model that aims to strengthen primary care through a regionally-based multi-payer payment reform and care delivery transformation.
The new CPC+ model builds on the previous Comprehensive Primary Care program, which launched in late 2012 and will run through December 31, 2016. CPC+ integrates many lessons learned from CPC, including insights on practice readiness, the progression of care delivery redesign, actionable performance-based incentives, necessary health information technology, and claims data sharing with practices.
CPC+ will include two primary care practice tracks, both of which include care delivery redesign to ensure practices in each track have the infrastructure to deliver better care to result in a healthier patient population.
The multi-payer payment redesign will give practices greater financial resources and flexibility to make appropriate investments to improve the quality and efficiency of care, and reduce unnecessary health care utilization.
In an Aug. 1 press release CMS Deputy Administrator and Chief Medical Officer Patrick Conway, M.D., said CMS views CPC+ as the future of primary care in the United States. He noted that payers involved in the project were "committed to supporting primary care practices of all sizes."
He specifically mentioned small, independent and rural practices. "This model allows primary care practices to focus on what they care about most -- serving their patients' needs when and how they (physicians) choose."
CPC+ will be available in 14 regions, which were chosen based on payer interest. The selected regions include the states of:
Also included are the North Hudson-Capital region in New York, the greater Kansas City area in Kansas and Missouri, northern Kentucky and greater Philadelphia.
What is the goal of the Comprehensive Primary Care Plus Initiative?
CPC+ will bring together CMS, commercial insurance plans, and State Medicaid agencies to provide the financial support necessary for practices to make fundamental changes in their care delivery.
CMS will enter into a Memorandum of Understanding (MOU) with selected payer partners to document a shared commitment to align on payment, data sharing, and quality metrics throughout the five year initiative of CPC+.
The goal of CPC+ is to improve the quality of care patients receive, improve patients’ health, and spend health care dollars more wisely. Practices in both tracks will make changes to the way they deliver care based upon key Comprehensive Primary Care Functions:
Planned Care and Population Health
In order to support the delivery of comprehensive primary care, CPC+ includes three payment elements:
Financial Summary Table that explains the two different tracks
In order to understand and assess care quality, CMS requires practices to adopt a CPC+ ready EHR that is capable of adopting many of the following workflow changes:
eClinicalWorks has signed a Memorandum of Understanding to assist practices who choose to pursue CPC+ for Track 1 or Track 2. For those looking to apply for Track 2, eClinicalWorks is on CMS’ approved vendor list and has signed the Health IT Vendor MoU which must be included with your application. eCW is also providing the following:
For more information and/or Practice Materials, Health IT Vendor Materials, and Payer Materials, visit https://innovation.cms.gov/initiatives/comprehensive-primary-care-plus
Leave us a comment below. Don't forget all applications must be submitted by September 15, 2016 at 11:59 EDT. Click here to register and submit your CPC+ application today.