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CMS payment model could change primary care for up to 25M Medicare beneficiaries

April 11, 2016
by Nicole Stempak, Senior Editor
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The Centers for Medicare & Medicaid Services (CMS) wants to change how primary care is delivered to seniors and paid for by Medicare.

CMS announced today its largest-ever initiative, the Comprehensive Primary Care Plus (CPC+) model, to give doctors freedom to care for patients how they see fit. Medicare will partner with commercial and state health insurance plans to support primary care practices in up to 20 regions. The CPC+ model can accommodate up to 5,000 practices to include more than 20,000 doctors and clinicians and the 25 million beneficiaries they serve.

"Strengthening primary care is critical to an effective healthcare system," says Patrick Conway, MD, CMS deputy administrator and chief medical officer in a press release. "By supporting primary care doctors and clinicians to spend time with patients, serve patients’ needs outside of the office visit and better coordinate care with specialists, we can continue to build a healthcare system that results in healthier people and smarter spending of our healthcare dollars. The Comprehensive Primary Care Plus model represents the future of healthcare that we’re striving towards."

The CPC+ model will help Medicare beneficiaries with serious or chronic disease achieve their health goals, give patients 24-hour access to care and health information, deliver preventive care, engage patients and their families in their own wellness and work with other healthcare professionals to provide better care coordination.

Primary care practices can apply to participate in one of two tracks. CMS will accept payer proposals to partner in CPC+ from April 15 through June 1. CMS will accept practice applications in the determined regions from July 15 through Sep. 1. The five-year CPC+ model begin Jan. 1, 2017. It will build on the Comprehensive Primary Care initiative ending Dec. 31, 2016, and on the success of tying an estimated 30 percent of Medicare payments to quality and value through alternative payment model.

For more information, read the CPC+ model program description at