Author: Tom Entrikin | Posted: 26. April 2012 12:22
The Centers for Medicare and Medicaid Services (CMS) announced on April 11 that it has accepted applications from state Medicaid agencies, other public payers, and private health insurance plans to participate in the Multi-Payer Comprehensive Primary Care (CPC) demonstration project authorized under section 3021 of the Affordable Care Act (ACA). CMS approved four statewide CPC initiatives that will serve individuals with high cost, high risk medical conditions in Arkansas, Colorado, New Jersey, and Oregon. CMS also approved three CPC initiatives serving the Albany/Hudson valley area in New York, the Cincinnati-Dayton area in Ohio, and the Tulsa, Oklahoma area. Applications were due on January 17. Successful applicants demonstrated strong multi-payer collaboration in their geographic areas. CMS estimates that 75 primary care providers will be enrolled in each of the seven geographic areas and that 330,070 Medicare and Medicaid recipients will receive care management through the CPC project over the next four years. Medicare will pay risk-adjusted care management fees to primary care practices on a per beneficiary per month basis (about $8-$40 per month, $20 per month on average), with opportunities for the primary care practices to earn a share of the Medicare savings that they achieve, beginning in the second year of the project. Multi-payer participation in the CPC project will enable primary care providers to spread the added costs of care management over a broader base and to qualify for shared savings from additional payers, achieving a higher overall return on their investment in care management innovation and the health information technology that they will need to support it. Participating payers in each of the seven geographic areas will enter into memoranda of understanding with CMS prior to official provider enrollment and implementation of the initiatives.
