New CMS Program To Provide Incentive Pay to Primary Care Physicians
On Wednesday, CMS announced a new plan that will give extra Medicare payments to primary care physicians who provide better care coordination, The Hill's "Healthwatch" reports (Baker, "Healthwatch," The Hill, 9/28).
The plan -- known as the Comprehensive Primary Care Initiative -- is part of the Center for Medicare and Medicaid Innovation, which was established by the federal health reform law to evaluate strategies to improve care and lower costs (Sanger-Katz, National Journal, 9/28).
Under the program, CMS officials will select five to seven health care markets in which the initiative will launch as a demonstration project (Walker, MedPage Today, 9/28). The initiative likely will involve about 75 practices in each market and include about 330,000 Medicare beneficiaries (Torres, "Capsules," Kaiser Health News, 9/28).
Health care providers will receive an extra $20 per patient monthly to help them invest in electronic health records, extra nurses or social workers to keep patients healthier (National Journal, 9/28).
- To qualify for the bonus payments, primary care practices must:
- Be available 24 hours daily to provide medical care and health information;
- Help patients follow a personalized care plan;
- Provide preventive care;
- Engage patients and their families in their own care; and
- Coordinate care with other physicians (MedPage Today, 9/28).
Participation by Insurers
Richard Baron, a CMMI official, said he hopes private insurers also will participate in the program (National Journal, 9/28). CMS hopes insurers will adopt a similar model in which PCPs receive bonus payments for better care coordination (MedPage Today, 9/28).
To participate, insurers must submit a nonbinding letter of intent by Nov. 15. Final applications are due in January 2012. Insurers will be selected in the spring, and then primary care physicians will apply. The program should be implemented next summer (Dick Tocknell, HealthLeaders Media, 9/29).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.