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.