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Practice Fusion · Jun 29, 2017

CMS expands Comprehensive Primary Care Plus (CPC+) to four new regions

  1. What is CPC+?
  2. How can CPC+ help my practice?
  3. Does Practice Fusion support CPC+?
  4. How do I apply?

Practice Fusion is partnering with practices participating in a new multi-payer initiative called Comprehensive Primary Care Plus (CPC+). By partnering with participating primary care practices, we hope to help facilitate primary care practices’ ability to manage their patient population’s health, leading to smarter spending, better care, and healthier people.

The Centers for Medicare and Medicaid Services (CMS) is seeking primary care practices in four new regions to apply for the second round of the CPC+ program taking place from 2018 to 2022. The new regions are:

  • Louisiana (Statewide)
  • Nebraska (Statewide)
  • North Dakota (Statewide)
  • Greater Buffalo, New York Region (Erie and Niagara Counties)

Eligible practices located in these regions can apply to participate in CPC+ Round 2 through July 13, 2017. Nearly 3,000 primary care practices are already participating in CPC+, and CMS expects to select up to 1,000 primary care practices in Round 2 of CPC+.

What is CPC+?

CPC+ is a five-year, multi-payer initiative designed to strengthen primary care through regionally-based multi-payer payment reform and care delivery transformation. CPC+ includes two primary care practice participation tracks with progressive delivery requirements and payment options to meet the diverse needs of primary care practices.

How can CPC+ help my practice?

CPC+ includes three core payment elements to support the delivery of comprehensive primary care:

  1. Care Management Fee (CMF): The program provides a non-visit-based CMF paid per-beneficiary per-month (PBPM). The amount is risk-adjusted for each practice to account for the intensity of care management services required for the practice’s specific population. The Medicare fee-for-service (FFS) CMFs will be paid to the practice on a quarterly basis.
  2. Performance-Based Incentive Payment: CPC+ will prospectively pay and retrospectively reconcile a performance-based incentive payment. This is based on how well the practice performs on patient experience measures, clinical quality measures, and utilization measures that encompass the total cost of care.
  3. Payment under the Medicare Physician Fee Schedule: CPC+ practices in Track 1 will continue to bill and receive payment from Medicare fee-for-service (FFS) as usual. CPC+ practices in Track 2 may also continue to bill as usual, but Medicare FFS payments will be adjusted to account for CMS shifting a portion of Medicare FFS payments into Comprehensive Primary Care Payments (CPCP). In addition, A CPC+ practice in Track 2 will generally be paid a CPCP in a lump sum on a quarterly basis absent a claim.

Does Practice Fusion support CPC+?

Practice Fusion’s EHR supports practices participating in both Track 1 and Track 2 of the CPC+ program.

How do I apply?

You can apply to participate in CPC+ Round 2 by applying through CMS’ website.

“The whole purpose of [CPC+] is a collection of records to provide better care so that patients stay out of the hospital. You have the care management coordinators that help the patients, and genuinely do care [about them]. It’s about patient care, and that’s why we’re all here. We want them to live long and healthy lives … and it is making a difference.”

– Jeanine Recupero, Office Manager and Practice Fusion customer

The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.