New Reimbursement Initiative for Primary Care in Colorado

May 20th, 2019 | Published Under HIE Participants by Jennifer Mensch

Last month, the Centers for Medicare & Medicaid Services (CMS) announced significant changes to the way primary care practices will be paid for managing Medicare beneficiaries. According to CMS, the program includes “Voluntary payment model options that reward value and quality through innovative payment structures while emphasizing the doctor-patient relationship supporting advanced primary care.”

Only 18 states, including Colorado, are eligible to participate in this new Primary Cares Initiative, that offers five different payment models to choose from under two paths: Primary Care First and Direct Contracting. All five models focus on care for chronically and seriously ill patients.

Practices not participating in the current program, CPC+, can apply now for this program that begins January 2020. CPC+ practices will need to wait until 2021 to participate.

The first step is to sign a Letter of Intent, which is available on the Direct Contracting Model Website. This is not a binding contract but is required before August 2, 2019 for practices to be eligible for the program when it starts.

For questions, here are some additional resources:

CMS Overview: https://innovation.cms.gov/Files/x/primary-cares-initiative-onepager.pdf

Direct Contracting Model Help Desk DPC@cms.hhs.gov

Direct Contracting web page https://innovation.cms.gov/initiatives/direct-contracting-model-options/

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