Healthcare Business News

Care-coordination initiative announced

By Melanie Evans
Posted: September 28, 2011 - 11:30 am ET

The CMS will pay primary-care doctors to better coordinate care under a pilot program that would require other public and private insurers to make a similar investment.

Primary-care doctors will receive an average of $20 per month for each Medicare fee-for-service enrollee to coordinate care in five to seven communities where most other insurers also agree to take part.

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The agency will pilot the effort under the Comprehensive Primary Care Initiative, federal health officials announced. Insurers must submit a letter of intent to participate by Nov. 15 (PDF) and formal applications by Jan. 17.

Care coordination payments or other support from public or private insurers “will be expected,” as part of the program, according to the solicitation. Insurers must also agree to shared savings; disclosure of cost and medical use data; and should be willing to coordinate quality and other measures.

Medical practices that participate in the program and meet quality measures will be eligible to keep a share of savings. Practices will apply next spring. Dr. Richard Baron, director of the seamless care models group at the CMS Innovation Center, said the initiative, which will begin next summer, is designed to provide primary-care doctors with funding and flexibility to manage chronically ill patients and coordinate care.

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