When the CMS announced the names of the 500 participants in its four-year Comprehensive Primary Care Initiative, the list included three OHSU primary-care clinics where residents are trained.
The CPCI begins with Medicare providing a $20 per-member, per-month care-management fee, with that sliding back to about $15 after the second year, when practices will be eligible to collect money from shared savings. Some private payers and state Medicaid programs are also participating in the CPCI, and—with Medicare, Medicaid and private payers combined—the program's goal is to have at least 60% of the participating practices' patient base covered by per-member, per-month fees. The intent is to have the practices use that money to invest in the staff and information technology necessary for care-coordination services that should help lower hospitalizations, eliminate duplicate testing and avoid other inefficiencies that drive up healthcare costs.
Patrick Gordon, program director for the Colorado Beacon Consortium and director of government programs for consortium member Rocky Mountain Health Plans of Grand Junction, Colo., says the program has the potential to "fundamentally change the economics of primary care."
"We're excited about this," Saultz says.
"We've been trying to change the way we train new (primary-care) physicians, nurses and social workers to practice in this model," Saultz added, explaining that the care-management fee can help support mental health services, outreach programs and home healthcare delivery.
Though it doesn't sound like much individually, he says the numbers add up, and said that—if a practice collects fees from 2,000 patients—it could equal "twice the salary of the average family doctor."
Dr. Glen Stream, president of the American Academy of Family Physicians, also endorsed the program.
"It aligns so much with our vision of the patient-centered medical home payment model," Stream said, though he added—in the AAFP's vision for payment reform—a pay-for-performance bonus would take the place of shared savings.
The 500 practices are in seven areas: New York's Capital District-Hudson Valley region; the Ohio-Kentucky Cincinnati-Dayton region; Tulsa, Okla.; and statewide in Arkansas, Colorado, New Jersey and Oregon. According to the CMS, most efforts will launch around Nov. 1, with Tulsa practices aiming for Oct. 1.
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Andis Robeznieks covers public health and wellness, military and veterans healthcare, academic medical centers, and healthcare construction and design. Before joining Modern Healthcare in 2005, he was the ethics and patient safety and quality reporter for American Medical News, the weekly newspaper published by the American Medical Association. He has a master's degree in journalism from the University of Illinois at Urbana-Champaign and a bachelor's in journalism from Eastern Illinois University.Follow on Twitter