CMS reward plan for coordinated primary care met with praise

The Centers for Medicare & Medicaid Services (CMS) on Sept. 28 announced a new program that aims to better align incentives to improve primary care. Under the Comprehensive Primary Care Initiative, funded by the Affordable Care Act, CMS will pay participating practices a monthly bonus to better coordinate primary care, for example, by offering expanded hours and intensive care management, Internal Medicine News reports.

According to CMS, physicians who meet the program goals will be eligible to receive $20 per Medicare beneficiary per month for the first two years of the program, which will begin next summer. The payment will be reduced to $15 for the second two years.

The plan was met with quick praise from doctors' groups, including the American Medical Association and the American College of Physicians, who each released statements commending the initiative's promise to improve care for patients.

Physician groups are especially in favor of CMS' plans to invite more companies and payers, including employer-sponsored and state health plans, to join the initiative. To participate in the Comprehensive Primary Care Initiative, public and private healthcare payers are required to submit a letter of intent by Nov. 15.

Despite the positive feedback, healthcare consultant Greg Mertz, senior partner with Healthcare Strategy Group, told Physicians Practice that the move could indicate that CMS is looking for more viable alternatives to its Accountable Care Organization program.

"[CMS is] looking at more acceptable alternatives," he said. "Basically this is a medical home program so the model is more common and likely to attract interest." He added that because payers--who want to reap a profit--will be in charge of managing risk for participating patients, the potential rewards to physicians may be diminished.

To learn more:
- read the article from Internal Medicine News
- read the article from Physicians Practice
- see the statement from the ACP
- see the statement from the AMA

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