Oregon Comprehensive Primary Care Plus

Program Location: 
OR
Number of Practices: 
156
Payer Type: 
Multi-Payer
Payers: 
AllCare Health Inc.
CareOregon
Eastern Oregon Coordinated Care Organization (EOCCO)
FamilyCare Health
InterCommunity Health Plans Inc. (IHNCCO)
Oregon Health Authority (Medicaid)
Moda Health Plan
PacificSource
PrimaryHealth of Josephine County
Providence Health Plan (PHP)
Providence Health Assurance (PHA)
Trillium Community Health Plan
UnitedHealthcare
Western Oregon Advanced Health LLC
Willamette Valley Community Health
Yamhill Community Care Organization Inc.

Reported Outcomes

Description: 

Oregon was selected by CMS to participate in the Comprehensive Primary Care Plus (CPC+) initiative which CMS touts as the “largest ever multi-payer initiative to improve primary care in America”. CPC+ is an advanced primary care medical home model that rewards value and quality through innovative payments that support comprehensive care. The initiative developed by CMS transitions Medicare fee-for-service to value based payments in collaboration with Medicaid and commercial payers. Over 150 practices in Oregon have adopted CPC+. All participating practices will be required to be recognized as a Patient- Centered Primary Care Home (PCPCH) by the Oregon Health Authority (OHA). This unique public-private partnership gives practices additional financial resources and flexibility to make investments, improve quality of life, and reduce the number of unnecessary services patients receive.

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.

 

Comprehensive Primary Care Plus

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