AMA Wire

Wednesday, June 13, 2012

This Week's News

Medicare-private payer partnership to fund primary care innovation

Medicare-private payer partnership to fund primary care innovation

A new federal initiative aims to support primary care physicians' efforts to innovate and improve care delivery.

The Comprehensive Primary Care Initiative is a collaboration among 45 federal, state and private health insurers that will offer monthly bonus payments to primary care physicians who better coordinate care for their patients. The Center for Medicare and Medicaid Innovation is administering the initiative, through which participating physicians initially will receive a monthly $20 care management fee for each Medicare beneficiary and enhanced payments from other participating insurers.

The increased payments are intended to help primary care physicians make specific enhancements to their care coordination, including ensuring continuous access to care, providing timely preventive care, engaging patients and caregivers, and coordinating care across the medical community.

"This initiative shows that the public and private sectors can come together to meet the critical need for these services," acting Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner said in a news release.

The pilot program would take place in eight states in which CMS has entered agreements with insurers. The four statewide markets are Arkansas, Colorado, New Jersey and Oregon. The three regional markets are the Capital District-Hudson Valley region of New York, the Cincinnati-Dayton region in Ohio and Kentucky, and the greater Tulsa region in Oklahoma.

Approximately 75 primary care practices will be selected to participate in the Comprehensive Primary Care Initiative in each designated market. Physicians who are interested in participating should complete an online pre-screening application. Applicants who meet minimum eligibility requirements will then receive an email with information about the full application and how to apply to the program.

The AMA supports this initiative and has urged CMS to pursue multipayer approaches to new payment and delivery models.