Wednesday, April 11, 2012

CMS Innovation Center Update: Comprehensive Primary Care Initiative

The following is an update from the CMS Innovation Center:

The CMS Innovation Center has selected seven geographic markets to carry out the Comprehensive Primary Care initiative, a new multi-payer approach that aims to strengthen the primary care system while achieving better health care and lower costs through improvement. These markets were selected based on a pool of applicants, which include private health plans, state Medicaid agencies, and employers, that proposed to pay for and support comprehensive primary care coordination in partnership with Medicare.

The markets represent a diverse range of regions spanning both coasts, the midwest and south, and rural and urban communities. The selected markets are:

  • Arkansas: Statewide
  • Colorado: Statewide
  • New Jersey: Statewide
  • New York: Capital District-Hudson Valley Region
  • Ohio: Cincinnati-Dayton Region
  • Oklahoma: Greater Tulsa Region
  • Oregon: Statewide

Once the participating payers in each market have agreed to the terms and conditions to participate in the initiative by entering into a Memorandum of Understanding with CMS, the Innovation Center will release the application for primary care practices to participate in each market. Approximately 75 primary care practices will be selected to participate in the initiative in each designated market.



These practices will receive a new care management fee on behalf of Medicare fee-for-service beneficiaries to support enhanced primary care services for their patients. The enhanced services will include: improved care coordination; increasing patients’ access to care; delivering preventive care; engaging patients and caregivers in managing their own care, and providing individualized, enhanced care for patients living with multiple chronic diseases and higher needs.

More information on these markets and the Comprehensive Primary Care initiative is available at innovation.cms.gov/initiatives/comprehensive-Primary-Care-Initiative.

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