Comprehensive Primary Care Plus (CPC+) is a five year nationwide initiative administered by the Center for Medicare & Medicaid Innovation (CMS Innovation Center). CPC+ is a partnership between payer partners from the Center for Medicare & Medicaid Services (CMS), state Medicaid agencies, commercial health plans, self-insured businesses and primary care providers. The goal of CPC+ is to strengthen primary care by focusing on high quality & high value care with an advanced care delivery and payment structure to achieve better care, smarter spending and healthier people. This program will allow for practices to be innovative in care delivery and payment redesign. Practices will receive financial support that will change the way they deliver care via care management fees (CMF) & performance-based incentives.
Practices will participate in two different tracks based on their readiness for transformation. Each track will have different payment methodologies and care delivery requirements. Practices in Track 1 will build capabilities to deliver comprehensive care and better meet the needs of their patients. Practices in Track 2 will have additional requirements and will enhance their comprehensive care delivery. Each track will focus on the five Comprehensive Primary Care Functions:
Function 1: Access & Continuity
Function 2: Care Management
Function 3: Comprehensiveness & Coordination
Function 4: Patient & Caregiver Engagement
Function 5: Planned Care & Population Health
Practices in all tracks will have access to national and regional learning communities, individual and small group coaching and actionable data. CPC+ qualifies as an advanced alternative payment model (APM) through the Medicare Access and CHIP Reauthorization Act (MACRA). The practice transformation team at Rocky Mountain Health Plans (RMHP) has been selected to provide practice facilitation services to practices in the CPC + in the Western Colorado region. RMHP are part of a larger CPC+ Regional Practice Network that is led by the Lewin Group in direct partnership with TMF Health Quality Institute and HealthTeamWorks.