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The U.S. Department of Health and Human Services (HHS) recently launched the Comprehensive Primary Care (CPC) initiative to improve primary care services and deliver higher quality, more coordinated, and patient-centered care. The CPC initiative is a multi-payer initiative intended to foster collaboration between public and private healthcare payers to enhance and improve the level of primary care services. Under the CPC initiative, Medicare will work with commercial and state health insurance plans to offer additional support to primary care doctors who better coordinate care for their Medicare patients.
The CPC initiative is voluntary and will begin as a demonstration project available in five to seven healthcare markets across the country. Primary care practices that choose to participate in the CPC initiative will be given support to better coordinate primary care for their Medicare patients. This support will help primary care doctors:
- Help patients with serious or chronic diseases follow personalized care plans;
- Give patients 24-hour access to care and health information;
- Deliver preventive care;
- Engage patients and their families in their own care; and
- Work together with other doctors, including specialists, to provide better coordinated care.
The CPC initiative will test two models simultaneously: a service delivery model and a payment model. The service delivery model will test comprehensive primary care, which is characterized as having the following five functions:
- Risk-stratified Care Management;
- Access and Continuity;
- Planned Care for Chronic Conditions and Preventative Care;
- Patient and Caregiver Engagement; and
- Coordination of Care Across the Medical Neighborhood.
Under the payment model, the Centers for Medicare and Medicaid Services (CMS) will pay participating primary care practices a monthly fee in addition to the usual Medicare fees that they would receive for delivering Medicare covered services. In addition, in years 2-4 of the initiative, the payment model will include the potential to share in any savings to the Medicare program from below target medical costs of the subject population. The participating primary care practices will also receive compensation from the other healthcare payers participating in the CPC initiative.
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