(Last Updated On: June 21, 2017)

On June 8th, 2017, CMS announced enrollment dates and locations for Round 2 of their Comprehensive Primary Care Plus (CPC+) program.(1) Currently, CPC+ has 54 aligned payers in 14 regions, which encompasses close to 3,000 primary care practices of varying sizes and structures. In support of delivering comprehensive primary care, CPC+ is a payment redesign that offers the financial resources and flexibility practices need to make investments that will improve primary care and increase revenue.(2)

CPC+ Round 2 Changes

To promote the shift from Fee For Service (FFS), CMS will be offering for CPC+ participants Comprehensive Primary Care Payments (CPCP), while at the same time, reducing FFS payments.(2) Typically CPCP payment amounts should be larger than the FFS payment amounts. CPCP payments will include a non-visit-based, monthly case management fee (CMF) and paying performance-based incentive payments (PBIP) for participants that meet or exceed annual performance thresholds.(2)

This effort to improve quality, access, and efficiency of primary care spotlights key CPCP functions. CMS believes that these payment structures will change the way practices deliver care and will shift focus to (1) Access and Continuity; (2) Care Management; (3) Comprehensiveness and Coordination; (4) Patient and Caregiver Engagement; and (5) Planned Care and Population Health.(1) Track 2 will also increase Information Technology requirements, which includes a letter from a supporting technology vendor such as CareHarmony.

As with Track 1, CPC+ cannot be combined with Chronic Care Management (CCM), which encompasses CPT Codes 99490, 99487, and 99489.

Enrollment Areas

CPC+ Round 2 will be offered in the following regions: (1)

  1. Louisiana: Statewide
  2. Nebraska: Statewide
  3. North Dakota: Statewide
  4. New York: Greater Buffalo Region(Erie and Niagara Counties)

Enrollment Dates

Eligible practices located in these regions may apply to participate in CPC+ Round 2 from May 18, 2017 until July 13, 2017. (1)

More Enrollment Information

CMS expects to add 1,000 practices in this round of enrollment. Practices are expected to participate for the full five-year performance period. However, there will be no penalty for voluntary withdrawal.

References

  1. Centers for Medicare & Medicaid Services, “Comprehensive Primary Care Plus,” 2017, June 08 [Online: June 14, 2017]. https://innovation.cms.gov/initiatives/comprehensive-primary-care-plus
  2. Centers for Medicare & Medicaid Services, “Comprehensive Primary Care Plus (CPCP+) Round 2,” 2017, May 17 [Online: June 14, 2017]. https://innovation.cms.gov/Files/x/cpcplus-practiceapplicationfaq.pdf