Healthcare Business News

Primary-care project set to launch

By Jessica Zigmond
Posted: October 24, 2011 - 1:30 pm ET

The CMS on Monday announced that 500 community health centers have been selected to participate in a three-year, advanced primary-care model demonstration project that will begin Nov. 1.

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Developed by the Center for Medicare and Medicaid Innovation and the Health Resources Services Administration, the Federally Qualified Health Center Advanced Primary Care Practice Demonstration will evaluate the effect of Medicare paying a care-coordination fee to participating community health-center practices in addition to the established all-inclusive-per-visit payment amount for the center to provide care coordination and management services that would be usually provided in an advanced primary-care practice. According to the CMS, the care-management fee would apply to all Medicare beneficiaries who receive medical care from participating community health centers as long as the beneficiaries remain eligible to participate.

The health centers will receive about $42 million over three years.

“Practices must shift from an acute care, complaint-driven primary-care paradigm that fragments healthcare delivery to one that is geared to maintain the patient’s overall health and anticipates when additional services or coordination needs occur,” the agency noted in a fact sheet (PDF) about the project.

According to the CMS, participating community health centers will receive a monthly care management fee of $6.00 for each eligible Medicare beneficiary attributed to their practice to help offset the costs related to shifting to a more coordinated primary-care practice. The agency anticipates that the initiative will provide healthcare for nearly 200,000 Medicare beneficiaries.

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