Newswise — Six Temple Physicians, Inc. (TPI) primary care practices have been selected to participate in a nationwide advanced primary care medical home initiative that aims to strengthen primary care through regionally-based, multi-payer payment reform and care delivery transformation.
The initiative – known as Comprehensive Primary Care Plus (CPC+) – features a partnership between payer partners from the Centers for Medicare & Medicaid Services (CMS), state Medicaid agencies, commercial health plans, self-insured businesses, and primary care providers. The partnership includes over 2,900 participating primary care practices nationwide and is designed to provide improved access to quality health care at lower costs.
The six TPI practices that were selected for the CPC+ initiative are: Temple Physicians at Rockledge, Temple Physicians at Fort Washington, Fox Chase Internal Medicine, Jamestown Family Medicine, Temple Physicians at Lawndale, and Temple Physicians at Palmer Park. The TPI CPC+ program will be administered in collaboration with the Temple Center for Population Health, LLC, which serves to improve health care delivery through clinical and business integration, community engagement and practice transformation.
“Truly patient-centered care requires a fundamental shift in the relationship between payers, physicians, and their patients,” said Marc P. Hurowitz, DO, MBA, FAAFP, Chief Executive Officer of TPI – Temple Health’s network of community-based specialty and primary-care physician practices.“Physicians must address their patients’ health-related needs beyond an acute care episode, make the practice’s resources more readily available to them, identify key medical and community resources to meet their needs, follow-up closely to ensure those needs are met, and facilitate more proactive care management than is typically seen in the current healthcare delivery system. The CPC+ initiative provides an infrastructure to boost our primary care physicians’ ability to do all of those things,” Hurowitz added.
“A robust primary care system is essential to achieve better care, smarter spending, and healthier people,” said Acting CMS Administrator Patrick Conway. “For this reason, CMS is committed to supporting primary care clinicians to deliver the best, most comprehensive primary care possible for their patients.”
Through CPC+, CMS will pay primary care practices a care management fee to support enhanced, coordinated services on behalf of Medicare fee-for-service beneficiaries. Simultaneously, participating commercial, state, and other federal insurance plans are also offering enhanced payment to primary care practices designed to support them in providing high-quality primary care on behalf of their members.
For patients, this means improved access to physician practices through longer and more flexible hours; improved health care communication through electronic health records; and the provision of individualized, enhanced care for patients living with multiple diseases and chronic conditions. The emphasis is on high quality care enhanced by patient engagement, prevention and coordinated care management.
The five-year model started on January 1, 2017, with CMS soliciting a diverse pool of commercial health plans, state Medicaid agencies, and self-insured businesses to work alongside Medicare to support comprehensive primary care. Public and private health plans in 14 regions across the country signed letters of intent with CMS to participate in this model, including Arkansas, Colorado, Hawaii, Kansas and Missouri’s Greater Kansas City region, Michigan, Montana, New Jersey, New York’s Capital District-Hudson Valley region, Ohio and Kentucky’s Cincinnati-Dayton region, Oklahoma, Oregon, Pennsylvania’s Greater Philadelphia Region, Rhode Island, and Tennessee. The markets were selected in August 2016 based on the percentage of the total population covered by payer partners who expressed interest in joining this partnership.
Eligible primary care practices in each market were invited to apply to participate in the winter of 2016. Through a competitive application process, CMS selected primary care practices within the selected markets to participate in CPC+. Practices were chosen based on their use of health information technology; ability to demonstrate recognition of advanced primary care delivery by leading clinical societies; service to patients covered by participating payer partners; participation in practice transformation and improvement activities; and diversity of geography, practice size, and ownership structure.
“TPI’s primary care practices have already earned the National Committee for Quality Assurance’s (NCQA) highest-level recognition as Patient-Centered Medical Homes,” noted Hurowitz. “I am proud that six of them have been selected to participate in CPC+ and now have the opportunity to leverage even further their care management and coordination expertise to improve quality, reduce avoidable hospitalizations, and decrease costs,” he added.
CPC+ is administered by the Center for Medicare & Medicaid Innovation (CMS Innovation Center). The CMS Innovation Center was created by the Affordable Care Act to test innovative payment and service delivery models that have the potential to reduce program expenditures while preserving or enhancing the quality of care. For more information about CPC+, visit: https://innovation.cms.gov/initiatives/comprehensive-primary-care-plus/