Last month, U.S. Department of Health and Human Services (HHS) Secretary Alex Azar and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced the CMS Primary Cares Initiative, a new set of voluntary payment models intended to transform primary care to deliver better value for patients throughout the healthcare system.
Building on the lessons learned from and experiences of previous and current models including the Comprehensive Primary Care Plus (CPC+) model and the Next Generation ACO model, CMS has announced the new initiative aimed at reducing administrative burdens and empowering primary care providers to spend more time caring for patients while reducing overall health care costs. Administered through the CMS Innovation Center (CMMI), the CMS Primary Cares Initiative will offer primary care practices and other providers participating in Medicare with five new payment model options under two paths: Primary Care First and Direct Contracting.
Both the Primary Care First and Direct Contracting models will incentivize providers to reduce hospital utilization and total cost of care by potentially significantly rewarding them through performance-based payment adjustments. Scheduled to begin in January 2020 with a second application round also planned for participants starting in January 2021, the models will be tested for five years. CMS anticipates these new payment model options could impact over 25 percent of all Medicare fee-for-service beneficiaries. (See here for more details.)