Skip to main content

All Access Subscription

Get unlimited access to our full publication and article library.

Get Access Now

Interested in Group Sales? Learn more

CMS Announces Regions, Application Period for Comprehensive Primary Care Plus

By Jill Drachenberg, Managing Editor, AHC Media

CMS listed the 14 regions, and opened the application period, for its new primary care medical home model, Comprehensive Primary Care Plus (CPC+), which is set to launch in January 2017.

The five-year model is a public-private multipayer partnership between Medicare, state Medicaid agencies, and private insurance companies to improve patient care, better manage chronic conditions, and lower costs for all involved.

The 14 regions, chosen based on coverage and physician/payer interest, include: Arkansas, Colorado, Hawaii, the Kansas City regions of Kansas and Missouri, Michigan, Montana, New Jersey, regions of New York, Ohio (including the northern Kentucky region), Oklahoma, Oregon, the greater Philadelphia region of Pennsylvania, Rhode Island, and Tennessee.

CPC+ includes two different payer tracks, with Track 1 receiving a monthly care management fee in addition to the regular Medicare fee-for-service payments, and Track 2 receiving the monthly fee in addition to reduced fee-for-service payments and an up-front percentage of expected Medicare Evaluation & Management claims. Track 2 is for practices treating patients presenting with complex care needs and more comprehensive care, according to CMS. The Track 1 care management fee will be an average of $15 per beneficiary per month, while Track 2 will average about $28 per beneficiary, including an additional $100 fee.

CMS is accepting applications from eligible practices through Sept. 15, 2016.

For more information on getting the most out of Medicare reimbursement from Alternative Payment Models, check out AHC Media’s on-demand webinar, Maximize Your Money Under MACRA.