CMS Selects Markets for New Primary-Care Payment Initiative

The CMS will launch an ambitious primary-care quality improvement initiative in 14 regions, including 11 whole states. The states include Arkansas, Colorado, Hawaii, Michigan, Montana, New Jersey, Oklahoma, Oregon, Rhode Island and Tennessee.

The markets for the Comprehensive Primary Care Plus, or CPC+, initiative were selected based on density and interest shown by practices and payers. Fifty-seven not-yet-named payers will participate. Other areas in the initiative are the Greater Kansas City, Mo., area; the North Hudson Valley in New York state; the Greater Philadelphia area; and a region that includes all of Ohio and northern Kentucky.

Under CPC+, the CMS and other insurers would pay physicians a monthly fee for patient primary-care visits. The new model aims to improve health outcomes and lower cost not only for Medicare beneficiaries, but also consumers enrolled in commercial plans and other coverage options, such as insurer-managed Medicaid plans.

The CMS said it would only launch the model in markets where there was significant private payer interest. Some plans reacted with concern over how the model was structured.

Go to top