CMS Launches a Multi-Payer ACO Effort

The Centers for Medicare and Medicaid Services is seeking private and public health insurers to participate in the Comprehensive Primary Care Initiative, a multi-payer and provider accountable care program that will include reliance on health information technology.


The Centers for Medicare and Medicaid Services is seeking private and public health insurers to participate in the Comprehensive Primary Care Initiative, a multi-payer and provider accountable care program that will include reliance on health information technology.

CMS will pay a per-beneficiary-per-month care management payment for comprehensive primary care services provided to Medicare fee-for-services beneficiaries, as well as beneficiaries of participating Medicaid plans. Medicare also will enable participating practices to share in savings in years 2 through 4 of the four-year pilot program. Medicaid payer participants will not offer a shared savings component.

The program, authorized and funded under the Affordable Care Act, will launch in select markets with about 75 primary care practices in each market.

The goals of the program are to have payers align strategies for supporting comprehensive primary care services, and to test whether these services, coupled with payment reform, meaningful use of health information technology, and data analytics to guide improvement will bring better care and health status while reducing costs.

CMS has issued a notice explaining the program, available here and being published Oct. 3 in the Federal Register. Additional information is available here.

 

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