Greater Philadelphia Comprehensive Primary Care Plus

Program Location: 
Philadelphia, PA
Number of Practices: 
214
Payer Type: 
Multi-Payer
Payers: 
Aetna
Independence Blue Cross/Keystone Health Plan East

Reported Outcomes

Description: 

The Greater Philadelphia Region was one of 14 locations selected to participate in round one of the Comprehensive Primary Care Plus (CPC+) initiative launched by CMS. The coverage areas include Bucks County, Chester County, Delaware County, Montgomery Country, and the Philadelphia County. CPC+ is an advanced five-year initiative designed to strengthen primary care delivery, promote better health outcomes, and control overall health care costs. The initiative developed by CMS and supported by Philadelphia’s private payers and hospitals transitions Medicare fee-for-service to value based alternative payment models in collaboration with Medicaid. This public-private partnership gives practices additional financial resources and flexibility to make investments, improve quality of life, and reduce a number of unnecessary services. For patients, this means that physicians may offer longer and more flexible hours; use electronic health records; coordinate care with patients’ other health care providers; better engage patients and caregivers in managing their own care; and provide individualized, enhanced care for patients living with multiple chronic diseases and higher needs.

Payment Model: 

Practices will enter one of two program tracks. The track dictates the care delivery capabilities practices will develop and the payment structure they will receive.

 

CPC+ includes two primary care practice tracks with incrementally advanced care delivery requirements and payment options to meet the diverse needs of primary care practices in the United States. The two tracks, which are comprehensive care and financial support will dictate the care delivery capabilities practices will develop and the payment structures that they receive. Practices in both tracks will make changes in the way they deliver care, centered on key Comprehensive Primary Care Functions: (1) Access and Continuity; (2) Care Management; (3) Comprehensiveness and Coordination; (4) Patient and Caregiver Engagement; and (5) Planned Care and Population Health.

 

CMS Comprehensive Primary Care Plus 

Improved Access: 

Now available in 18 regions.

Last updated March 2019
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