APR 11, 2012 4:31pm ET

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CMS to Test New Primary Care Program in 7 States

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The CMS Center for Medicare & Medicaid Innovation will start the reform law-authorized Comprehensive Primary Care Initiative in seven states. The initiative is a multi-payer and provider accountable care organization program that will include reliance on health information technology.

Under the program, 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 two through four of the four-year pilot program. Medicaid payer participants will not offer a shared savings component.

The Centers for Medicare and Medicaid Services announced the Comprehensive Primary Care Initiative in late 2011. 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.

The initiative will start statewide in Arkansas, Colorado, New Jersey and Oregon. It also will launch in the Capital District-Hudson Valley region of New York, the Cincinnati-Dayton region of Ohio and the Greater Tulsa region of Oklahoma. CMS will select about 75 primary care practices in each designated market. More information is available here.

Comments (14)
Let's be clear... This was already tried! Panels,HMO with capitation,PHOs and all failed, drowned by red ink. My pts. pay more for insurance and I get paid same or less for years. Guess where the money went? Insurance co, lawyers, paperpusher. Let's look for savings there!
Posted by Michael A | Tuesday, September 25 2012 at 9:32PM ET
Michael A. is correct. We are constantly bombarded with the escalation of healthcare cost the news, and with the exception of this year - the costs of Medicare going up 3% to 5% every year, indemnity health insurance (i.e. Blue Cross for one) going up as much as 8% to 10% every year. None of these increases have been passed to the treating physicians. At best, we have been flat rated for the last three years and in many cases, paid less. So where is this money going?
Posted by DENNIS G | Monday, November 19 2012 at 7:55AM ET
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