CMS Seeks New Way of Delivering Primary Care

The Centers for Medicare and Medicaid Services has issued a request for information as it considers new models, including payment mechanisms, to encourage more comprehensive delivery of primary care.

The RFI also seeks ideas on how information technologies can support the new initiative, which could include “moving payment for primary care services from encounter-based, or encounter-based with care management fees (as is being tested in the Comprehensive Primary Care Initiative), towards population-based payment based on a practice’s population of beneficiaries.”

Other topics CMS wants covered include:

* Greater depth and breadth of care through longitudinal relationships between patients and PCPs;

* Care of patients with complex needs and closer connections between PCPs and other clinicians and community-based services;

* Mechanisms to support small PCP practices in transforming to advanced primary care;

* Advanced primary care within accountable care organizations, along with multi-payer participation and performance measurement that is meaningful to beneficiaries and clinicians; and

* Matching documentation requirements to the goal of advanced primary care while protecting CMS program integrity.

Particularly to the role of health information technology, CMS asks: “What transformative changes to HIT--including electronic health records and other tools--would allow primary care practices to use data for quality measurement and quality improvement, effectively manage the volume and priority of clinical data, coordinate care across the medical neighborhood, engage patients, and manage population health through team-based care (e.g., transitioning from an encounter-based to a patient-based framework for organizing data, using interoperable electronic care plans, and having robust care management tools)?”

The request for information is available here (scroll down to “Request for Information (RFI) (PDF”). Comments are due by March 16.