Providers working in 11 states and several other markets are now eligible to apply for an advanced primary care model that will dole out up to $100 per patient, per month in upfront payments.
The Comprehensive Primary Care Plus (CPC+) model, which officially launches in January 2017, is now accepting applications in 14 regions, according to a
CMS release. Those regions include the following states: Arkansas, Colorado, Hawaii, Michigan, Montana, New Jersey, Oklahoma, Oregon, Rhode Island and Tennessee.
In another effort by CMS to move Medicare payments out of the traditional fee-for-service framework, the CPC+ model seeks to reorient some of the operating principles of primary care -- centered largely around improved care coordination and enhanced patient access to care -- and to align payments on outcomes measures.
The application deadline is September 15, 2016.
CMS estimates that the average per-patient monthly fee paid to reflect care management services will be $28 for the advanced track of the CPC+ model, although the agency projects that the per-patient reimbursement figure may rise to as high as $100 for at-risk beneficiaries. Estimated care management fees for the lower-level track are $15 per patient per month.
The upfront fees will come in the form of "lump sum" quarterly payments to reflect the investment in expanded care management, and providers will also have the opportunity to gain additional reimbursement based on their performance, according to the CMS fact sheet.
"CPC+ will prospectively pay and retrospectively reconcile a performance-based incentive based on how well the practice performs on patient-experience measures, clinical quality measures and utilization measures that drive total cost of care," states CMS.
In addition to the 11 states mentioned above, providers in four other markets will be eligible to participate in the CPC+ model. Those markets includethe greater Kansas City area, the North Hudson-Capital region in New York, northern Kentucky and the greater Philadelphia region.