ACHP health plans are participating in new Medicare payment models, maintaining their leadership in transforming health care. Four member plans have been invited to join a Centers for Medicare and Medicaid Services (CMS) initiative improving primary care by paying physicians based on quality.
Capital District Physicians’ Health Plan (CDPHP), CareOregon, Priority Health and Rocky Mountain Health Plans are among the 57 health plans in 14 regions partnering with CMS on the Comprehensive Primary Care Plus (CPC+) initiative. Regions were selected based on payer interest and coverage. The CPC+ model bases compensation on the quality of care and care management provided by primary care physicians. CPC+ extends to all patients, including consumers enrolled in Medicare, Medicaid and commercial health plans. The initiative will benefit patients by providing more coordinated care, engaging individuals and families in their own care and supporting those with chronic diseases.
“We are excited to participate in CPC+. Joining forces with other payer partners, including Medicare, will help us deepen the primary care transformation work we’ve been doing now for many years. We believe it takes all of us supporting primary care together to achieve the Triple Aim,” says CareOregon Executive Director of Network Services Mindy Stadtlander, MPH.
“There’s a collective gain for us all to work together to help transform not only Priority Health’s business, but the business of health care for the entire state of Michigan,” says Priority Health COO Michael Koziara.
Successful participation in CPC+ requires effective solutions to challenges associated with alternative payment models (APM). The model is one of several HHS initiatives supporting the transformation of care through the Center for Medicare and Medicaid Innovation (CMMI) and the Health Care Learning and Action Network (LAN). HealthPartners Senior Vice President and Medical Director Charlie Fazio, M.D., is a member of the LAN Guiding Committee, the organization’s leadership body, and chairs its Payer Action Committee.
“I like the potential in CPC+ and other payment collaboratives to lessen administrative hassles for clinicians and increase the prospects for real innovation around the Triple Aim,” says Dr. Fazio.
Part of the LAN’s mission is to accelerate the transition to APMs. CDPHP, an ACHP member, has participated in case studies testing APMs. CDPHP used a global payment model that produced a 2.9 percent overall cost reduction and $20.7 million in total savings in 2014.
Strengthening primary care is critical to promoting health, reducing overall costs and improving consumer experience in the U.S. The CPC+ initiative will begin January 2017.
ACHP and our members improve the health of the communities we serve and actively lead the transformation of health care to promote high-quality, affordable care and superior customer service.