Austin, Texas – August 1, 2016 – The Centers for Medicare & Medicaid Services (CMS) has announced 14 geographic regions eligible for participation in Comprehensive Primary Care Plus (CPC+), a new advanced primary care medical home model that rewards value and quality by offering an innovative payment structure to support comprehensive primary care. Statewide regions announced are Arkansas, Colorado, Hawaii, Michigan, Montana, New Jersey, Ohio, Oklahoma, Oregon, Rhode Island, and Tennessee. Additional regions are the Greater Kansas City Region of Kansas and Missouri; the North Hudson-Capital Region of New York; Northern Kentucky and the Greater Philadelphia Region in Pennsylvania.
Under CPC+, Track 1 and Track 2 participants are paid an average of $180,000 to $320,000 per 1,000 patients per year, respectively, for care management fees, in addition to fee-for-service payments, and are also eligible for $30,000 to $48,000 per year in incentive bonuses. In addition, Track 2 primary care providers can also get as much as 71.5% of the reimbursement previously confined to face-to-face visits, using patient-pleasing methods such as phone, email, or text. All procedures and routine office visits are still fully billable under the physician fee schedule, sometimes at higher rates.
The CPC+ program includes Medicare, Medicaid and commercial insurers. Although similar, different payers may have different payment models or requirements. As a Qualified Advanced Payment Model, providers will also receive a MACRA payment of 5% of Part B billing for five years and will be exempt from the Quality Payment Program if the practice has fewer than 50 physicians, with no down-side risk.
Caravan Health makes qualification and participation in CPC+ simple with the same easy-to-implement programs used today by 23 of the nation’s most successful Medicare ACOs. Caravan Health also has an application success rate greater than 90%, resulting in more than 10% of Million Hearts practices, 50% of AIM-funded ACO’s and a 20% of all new ACO’s begun in 2016.
The CPC+ application period runs from August 1st through September 15th. There will be up to 5,000 eligible practices notified in October 2016 and the program begins January 1st, 2017. If you are missing any of the eligibility requirements, Caravan Health can qualify your practice for either track of CPC+ in a few short weeks. Using support from a Practice Transformation Network, Caravan Health can help you apply and set up all of the qualifying programs at no cost in time for you to be eligible. For more information, go to www.caravanhealth.com.
916 542 4583