Overview of CMS Innovation Center PCMH Initiatives

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Presentation transcript:

Overview of CMS Innovation Center PCMH Initiatives Demonstration Multipayer Advanced Primary Care Practice Demonstration Federally Qualified Health Centers (FQHC) Advanced Primary Care Practice Demonstration Comprehensive Primary Care Initiative (CPCI) Geographic scope ME, MI, MN, NC, NY, PA, RI, VT 500+ clinic sites in 44 states Seven “markets”: Statewide: AR, CO, NJ, OR; Mid-Hudson/Capital (NY); Cincinnati-Dayton (OH); and Greater Tulsa (OK) Participants Up to 1,200 practices (MD & NP) participating in state health care reform initiatives promoting APCP FQHCs (and “look-alikes”) serving relatively large numbers of Medicare beneficiaries 45 payers (commercial, states, unions) 500 primary care practices 2,144 providers serving an est. 313,000 Medicare beneficiaries Practice qualifications Dependent on state program > 200 Medicare beneficiaries per site High-performing practices Targeted beneficiaries Medicare beneficiaries Payment Care management fee, established by state multipayer reform initiative Medicare all-inclusive rate plus $6.00 PMPM care management fee Average $20 PMPM (risk-adjusted) years 1–2 Average $15 years 3–4 Opportunity for shared savings starting in year 2