April Month in Review: Primary Care Alphabet Soup - Insight on CPC+, MACRA, MIPS, APMs, PCMH, oh my!

Alphabet Soup in April
Thursday, April 28th

Dear Members and Friends, 

Hungry for payment and delivery reform? This month finds us analyzing the alphabet soup of care delivery and payment reforms just delivered from the Centers for Medicare and Medicaid Services (CMS): the CPC+ program and the MACRA proposed rule.

Announced on April 11, the new Comprehensive Primary Care Plus (CPC+) will be the largest-ever initiative to transform and improve how primary care is delivered and paid for nationwide (read our public statement). CPC+ builds on lessons learned from the original Comprehensive Primary Care Initiative (CPC) multi-payer pilot. Among other improvements, CPC+ includes up-front payment to all participating practices and a new hybrid payment track that pays for care that best serves the patient’s needs. This may include communication over the phone, via email, visits to alternative locations (such as senior centers), or through longer visits for patients with complex needs. This model places needed priority on the healing relationship between clinicians, care teams, and the patients they serve. CPC+ is expected to reach a potential 3.5 million Medicare fee-for-service (FFS) beneficiaries – as well as millions more Medicare Advantage, Medicaid, and commercial patients. 

And just yesterday, the Medicare Access and Chip Reauthorization Act (MACRA) proposed rule was released. The law shifts Medicare’s fragmented and volume-based FFS payment system to one that rewards value. As we dive into the details of the complex regulation, an easy-to-understand video developed by the U.S. Department of Health and Human Services helps explain MACRA to the masses: 

As we analyze the appetizing details to support and sustain high-performing primary care, we encourage you to share your feedback. We will soon be convening our interested executive members in order to coordinate a thoughtful, unified response to the MACRA proposed rule. This effort will be critical since MACRA will determine the fundamental infrastructure for primary care payment for years to come. We need your engagement now more than ever.

As always, we’re grateful for your support as we continue to make “Primary Care, Our Primary Cause!”

Marci Nielsen, PhD, MPH
President & Chief Executive Officer

National Briefing Webinar TODAY:
MACRA, MIPS, APMs & CPC+: What to Expect from all these Acronyms? 
The Medicare Access and CHIP Reauthorization Act (MACRA), signed into law last year, eliminates the failed Medicare Sustainable Growth Rate (SGR) formula, but also fundamentally revamps how Medicare pays physicians. This presentation will offer insight on MACRA with a special focus on the new proposed rule released yesterday by the Centers for Medicare and Medicaid Services (CMS). What's in the proposed rule, and how can we respond to best support advanced primary care? The presentation will also address how MACRA intersects with the new Comprehensive Primary Care Plus model, announced by CMS earlier this month.

Be among the first to hear policy experts discuss the proposed rule and join us TODAY, April 28th at 1:00 pm ET for our April National Briefing Webinar!

This Month's Top 5 Must Reads
Evaluation of the Comprehensive Primary Care Initiative: Second Annual Report
Mathematica Policy Research | April 2016

Medicare's New Physician Payment System
Health Affairs Policy Brief | 4/21/16

Two-Year Costs and Quality in the Comprehensive Primary Care Initiative
New England Journal of Medicine | 4/13/16

Medicare's Vision for Advanced Primary Care: New Directions for Care Delivery and Payment
JAMA | 4/11/16

Medical Homes May Help Improve Care for People with Mental Health Issues
The Commonwealth Fund Blog | 4/05/16

View additional news articles and studies on our website at pcpcc.org/news.
PCPCC at Forefront of CPC+

Since the Centers for Medicare and Medicaid Services (CMS) announced the creation of Comprehensive Primary Care Plus (CPC+), the PCPCC has been at the forefront analyzing the new model and creating resources for its executive members and other stakeholders. We invite you use any of the following to help enhance your understanding of CPC+ and guide your work: 
Below is a sample of some of the media coverage of CPC+ that mentions or features the PCPCC: 

New CMS Initiative a Pivotal Point in Primary Care Market
Computer World | 4/20/16

New Obamacare Program May Make Medical Homes More Common
Governing Magazine | 4/12/16

CMS Initiative Aims to Shake Up Primary Care
Bloomberg BNA | 4/12/16

CMS Unveils Value-Based Patient-Centered Primary Care Model
HealthIT Analytics | 4/12/16

Obamacare to Launch New Payment Scheme
POLITICO| 4/11/16

Health Datapalooza 2016 to Convene Top Health Data & Policy Experts


Let Your Inner Geek Shine and Don't Miss the Health Data Party of the Year!

PCPCC is proud to co-sponsor Health Datapalooza 2016 in partnership with AcademyHealth May 8-11 in Washington, DC. It provides a gathering place for people and organizations creating knowledge from data and pioneering innovations that drive health policy and practice, and generate market value. Check out the impressive list of speakers, and register to attend the meeting that brings data to life in ways that matter in health. 

This conference will bring us closer to the reality of using data, analytics, and technology to redefine how we deliver and pay for health care. Come and learn how data sharing, use, and transparency fuels innovative applications and business models that are building momentum toward a vibrant health information economy that drives high-value health care. 

Integrated Primary Care Alliance Convenes Experts, Creates Implementation Plan Supporting Behavioral Health Integration

PCPCC President & CEO Marci Nielsen, PhD, MPH, spoke at an invitation-only Integrated Primary Care Alliance meeting, hosted by the American Psychological Association April 8-9. The meeting provided an opportunity for primary care organizations to come together about the critical issues related to successful implementation and outcomes of integrated primary care, as well as create an outline for a new inter-organizational action plan that moves integrated primary care forward in an effort to improve our nation's health.

Practice Transformation Corner
The PCPCC Support & Alignment Network (SAN) is part of the larger Transforming Clinical Practices Initiative (TCPI), a new federal initiative launched in 2015 to guide and support practices as they transform the way they deliver care. 
This month, CMS officials announced that all practices participating in CPC+ are required to convene a Patient and Family Advisory Council (PFAC). Meaningful partnership with patients and families is critical to successful practice transformation. For more information on PFACs and other innovative ways to engage patients and families in quality improvement, see the PCPCC's SAN Resource Library and join the Institute for Patient- and Family-Centered Care's online PFACNetwork

PCPCC's New Online Map


The PCPCC will launch a new online map next month that tracks where and how ambulatory care practices are partnering with patients and families in practice transformation. To highlight the work your practice, hospital, or health system is doing to engage patients and families in care delivery, complete our brief form here.   
May 5th Webinar on Clinical Partnerships with Community-Based Organizations
Topic: Leaders from the YMCA of the USA and the American Medical Association (AMA) will discuss their Center for Medicare and Medicaid Innovation (CMMI) demonstration project to deliver the YMCA’s Diabetes Prevention Program to nearly 8,000 Medicare recipients. This three-year project led to the March 23 announcement by U.S. Department of Health and Human Services (HHS) that the successful demonstration project has been shown to produce significant cost savings for Medicare participants, marking a critical step for HHS to eventually expand the Diabetes Prevention Program under Medicare for those with prediabetes.

Date: Thursday, May 5th, 4:00 - 5:00pm ET
  • Matt Longjohn, MD, MPH, National Health Officer from YMCA of the USA (Y-USA)
  • Omar Hasan, MBBS, MPH, MS, FACP, the American Medical Association (AMA)

Welcome New Executive Members!

The National Center for Interprofessional Practice and Education is a unique public-private partnership charged by its funders to provide the leadership, evidence and resources needed to guide the nation on the use of interprofessional education and collaborative practice as a way to enhance the experience of health care, improve population health and reduce the overall cost of care. The National Center for IPE accomplishes this mission by aligning interprofessional education and collaborative practice (the “new IPE”) with transforming health care delivery. 

Founded in 1994, The Compliance Team (TCT) is the first privately held, certified woman-owned healthcare accreditation organization to receive deeming authority from Medicare (CMS). Its mission is to promote healthcare delivery excellence through sustainable quality improvement regimens that are not difficult or costly to realize, while establishing SAFETY-HONESTY- CARING® as core patient relationship values. This year, it is launching a new patient-centered medical home recognition program for small independent primary care practices. To date, TCT has accredited more than 5000 provider locations in all 50 states, Puerto Rico and the U.S. Virgin Islands including 1500 provider locations in designated rural areas. 
PCPCC on the Road
PCPCC President & CEO Marci Nielsen, PhD, MPH, will be busy on the road next month as she fulfills several speaking engagements. She'll kick off the month attending the American Board of Family Medicine Board meeting May 1-3.  From there, she'll travel back to Washington DC to attend the American College of Physician's Capitol Hill Leadership/Advocacy Day, as well as the CMS Comprehensive Primary Care Conference (May 4-5). She will then head back west to present the keynote address at the AHRQ-supported Colorado SIM collaborative learning session in Denver on May 6th. May 8-11, she'll participate in Health Datapalooza 2016, hosted by AcademyHealth. Then, she will close out May by speaking at the Maine Health Access Foundation's Community-Based Initiatives Learning Meeting. Follow Marci on Twitter @Marci_PCPCC to stay in touch!

Upcoming Events

April 28 - May 31

The Medi Community Resource Center Forum
April 28 | Washington, DC

Health Dataplooza
May 8-11 | Washington, DC

Brief Interventions for Anxiety in Primary Care Behavioral Health (PCBH)
May 11 | Webinar hosted by the Collaborative Family Healthcare Association

Health and Housing 101: Understanding the Intersections
May 11 | Conference call hosted by Community Catalyst

Accelerating the Use of Evidence in Health Care Practice, Policy, and Decision Making
May 12 | Mathematica Policy Research, Washington, DC

Changing Perception: How to Build Cultural Competence and Humility
May 12 | Webinar hosted by the National Center for Medical Home Implementation

Working to Improve Care for Older Adults: Using Data for Policy Change
May 16 | Webinar hosted by the Community Catalyst Center for Consumer Engagement in Health Innovation

Perspectives in Primary Care Case Study: Camden Coalition of Healthcare Providers
May 18 | Harvard Medical School, Center for Primary Care, Boston, MA 

PCPCC Executive Member Monthly Briefing
May 24 | Webinar

PCPCC National Briefing Webinar
May 26 | Webinar

Save The Date! 

PCPCC 2016 Annual Fall Conference
Nov. 9 - 11  l  Washington, DC, Grand Hyatt Washington

For additional events, click here.

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