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CMS Unveils 5 New Payment Models to Overhaul Primary Care: 6 Things to Know

CMS' Innovation Center is launching an initiative that provides primary care practices with five new payment options, including three direct contracting models.

Six things to know:

1. The CMS Primary Cares Initiative will provide the new payment model options under two paths: Primary Care First and Direct Contracting.

2. The two payment models offered under the PCF track are aimed at individual primary care practices, while the DC model options are aimed at larger practices, health systems, and other organizations that have experience with risk-based contracts.

3. All of the new model options link performance to payments to varying degrees. CMS said the PCF options seek to reduce hospital use and total cost of care through performance-based adjustments. The DCF payment options provide participants with a range of financial risk arrangements and focus on care for patients with complex, chronic needs and serious illness.

4. The PCF models will be tested for five years and are slated to begin in January 2020. Two of the DC options will begin in January 2020 with an initial alignment year, and a third option, the geographic model, is expected to launch in January 2021 and run for five years.

5. CMS expects 25 percent of primary care providers to join one of the five models.

6. The American Medical Association is pleased with the new payment options.

"Providing adequate financial support for high-quality primary care must be an essential element of any strategy to improve the quality and affordability of our country’s healthcare system," Gerald E. Harmon, MD, immediate past chair of the AMA board of trustees, said in a press release. "Many primary care physicians have been struggling to deliver the care their patients need and to financially sustain their practices under current Medicare payments. The new primary care payment models announced today will provide practices with more resources and more flexibility to deliver the highest-quality care to their patients."


INDUSTRY NEWS TAGS: CMS


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