PCPs in only 4 states can join new CPC+ advanced APMs in 2018

by Roy Edroso on May 17, 2017

Providers in four states get an opportunity to join the Comprehensive Primary Care Plus program (CPC+) and become an advanced alternative payment model (APM).

Joining 2,891 practices in 14 regions of 11 states that have already joined round one of the program will be up to 1,000 practices in four new round two regions: Louisiana, Nebraska, North Dakota and the Greater Buffalo Region (Erie and Niagara Counties) of New York State. Round 2 selectees will start the program Jan. 1.

The new regions were chosen “based on payer alignment and market density to ensure that CPC+ practices have sufficient payer supports to make fundamental changes in their primary care delivery,” says CMS in an announcement.

CPC+ round one was inaugurated April 11, 2016, as a pay-for-performance CMS program in which the agency works with private insurers to pay participating primary care providers per-beneficiary, per-month (PBPM) fees – called “care management fees” in this context -- of between $6 and $100 a patient in addition to fee-for-service payments.

New round two entrants will have a chance to join track 1 – which current members are in – or track 2. While “track 1 is intended for practices that have the health information technology and other basic infrastructure necessary to deliver comprehensive primary care, track 2 is intended for practices proficient in comprehensive primary care that are prepared to increase the depth, breadth and scope of medical care delivered to their patients, particularly those with complex needs,” CMS says.

The average fee per member in track 1 is $15, and the average for track 2 practices will be $28. Most current members in the round one states (Arkansas, Colorado, Hawaii, Michigan, Montana, New Jersey, Ohio, Oklahoma, Oregon, Rhode Island and Tennessee) will not be eligible to move to track 2.

CPC+ practices qualify as advanced APMs, and providers in those practices who meet qualified provider standards may be exempt from the Quality Payment Program’s merit-based incentive payment system (MIPS).

Interested primary care practices may learn more and apply through July 13, 2017, here.

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