The CMS Center for Medicare and Medicaid Innovation led “Comprehensive Primary Care” (CPC) initiative is a new multi-payer initiative to foster collaboration between public and private healthcare payers.
The CPC initiative offers a way for payers to join with Medicare to invest in primary care in 5 to 7 selected locations across the country with approximately75 practices in each market serving up to 330,750 Medicare and Medicaid Beneficiaries over four years.
The CPC initiative will test two models such as a service delivery model and a payment model simultaneously. The service delivery model will test comprehensive primary care while providing planned care for chronic conditions and preventative care, engage patients and caregivers, and coordinate care.
The payment model includes a monthly care management fee paid to the selected primary care practices on behalf of their fee-for-service Medicare beneficiaries and in years 2 to 4 examine the potential to share in any savings to the Medicare program.
Building in the “medical home” concept, the CPC initiative aligns multi-payer reform with practice transformations while holding practices accountable for total cost of care. Practices will be able to engage in systematic data sharing and collaborative learning experiences and share savings achieved at the market level.
Practices will also receive compensation from other payers participating in the initiative that will include private insurance companies and other health plans to enable them to integrate multi-payer funding streams.
The first step for public and private payers including states if interested is to submit a nonbinding Letter of Intent (LOI) and a completed Geographic Service Area Worksheet by November 15, 2011 sent via email to CPC@cms.hhs.gov.
Final applications are to be completed only after the LOI has been submitted with final applications due by January 17, 2012. Once CMS evaluates the proposals and selects the markets, a second solicitation will be issued recruiting and selecting primary care practices in those markets.
Go to http://innovations.cms.gov/documents/pdf/cpc_initiative_solicitation.pdf to view the solicitation.