The Centers for Medicare & Medicaid Services has selected 500 provider practices in seven regions to participate in a multi-payer initiative to improve primary care.
Medicare will work with state Medicaid agencies, commercial health plans and self-insured businesses, and offer bonus payments to primary care doctors who better coordinate care for their patients, according to a CMS announcement.
Practices selected to participate in the four-year Comprehensive Primary Care initiative are in Arkansas, Colorado, New Jersey, Oregon, New York's Capital District-Hudson Valley region, Ohio and Kentucky's Cincinnati-Dayton region, and the Greater Tulsa region of Oklahoma.
Participating practices were selected through a competitive application process based on their use of health IT and their ability to provide advanced primary care and practice-transformation efforts, among other criteria. That means they might provide longer and more flexible hours, better coordinate care with other providers for patients with multiple conditions and are better able to engage patients and caregivers in managing their own health.
The practices will be awarded a care-management fee from CMS, initially averaging $20 per Medicare patient per month in years one and two and growing to $15 in years three and four to support enhanced, coordinated services, reports Health Data Management. State and private health plans also will offer enhanced payment to these practices as they work together to enhance primary care.
More than 300,000 Medicare beneficiaries are expected to be served by more than 2,000 providers through this initiative. Participating providers and payers can be found on the CMS website.
In an interview with FierceHealthPayer last month, Charles Kennedy, Aetna's CEO of accountable care solutions, called technology a "foundational requirement" of ACOs.
An ACO targeting the Medicaid population has lined up participants in Maine, Massachusetts, Minnesota, New Jersey, Oregon, Texas and Vermont, as well. The 14-month collaboration called "Advancing Medicaid Accountable Care Organizations: A Learning Collaborative," specifically targets low-income populations to improve care and cut costs.
More states are looking into ACOs as a way to manage their costs, but this resource-intensive population--the chronically ill and low-income patients--bring a level of risk that could disrupt the whole ACO concept, FierceHealthcare recently reported.
To learn more:
- here's the announcement
- check out the CMS website
- read the Health Data Management article