If the patient-centered medical home supported by per-member, per-month care-management fees becomes the standard primary-care practice model, then Oregon Health & Sciences University in Portland can claim to be its first training ground.
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."