PORTLAND, OR––Oregon is one of 14 regions selected to implement a national model that provides more care options for patients and new ways for paying health care providers.
The model, Called Comprehensive Primary Care Plus (CPC+), builds on primary care options and delivery, and serves as a critical piece in transforming Oregon’s health care system.
The model furthers Oregon’s commitment and progress toward changing the way health care is paid for between providers and payers or insurers. By moving away from fee-for-service reimbursement to one that rewards value, Oregon has made great strides toward achieving better health, better care and lower costs. The CPC+ initiative brings Medicare, commercial insurers and coordinated care organizations together under a common model that aligns payment methods, engages patients and allows for better coordination.
Administered by the Centers for Medicare and Medicare Services (CMS), CPC+ is designed to improve the quality of care patients receive and their overall health, while spending health care dollars better. To encourage outcomes, CPC+ also provides financial incentives for health care providers when they meet performance measures are met.
“The CPC+ model strengthens the foundation of primary care by aligning payment options and giving providers the flexibility they need to provide the best care to patients,” said Leslie Clement, Oregon Health Authority’s (OHA) director of health policy and programs. “In the past, a health care provider may have been limited in the type of care they could provide based on a patient’s coverage or how they would be reimbursed for their services.”
By aligning Medicare, Medicaid and private insurance, the payment model continues to move the health care system away from a rigid, fee-for-service environment to a model that supports clinicians delivering the care that best meets the needs of their patients.
“The CPC+ primary care home model builds on our momentum toward providing better health, better care and lower costs,” said Jim Rickards, M.D., OHA’s chief medical officer. “Being chosen to implement this model speaks to our success in working together toward solutions while propelling work already underway.”
This innovative approach aligns with CMS’s and other payer partners’ approaches to improving care delivery and health outcomes. Building on the initial Comprehensive Primary Care initiative that launched in late 2012, the CPC+ model will benefit patients by helping primary care practices:
- Ensure patient access.
- Engage patients and their families in their own care.
- Work together with hospitals and other clinicians, including specialists, to provide better coordinated care.
CPC+ is aligned with Oregon’s Primary Care Transformation Initiative outlined by the Oregon Legislature in Senate Bill 231. The CPC+ program begins in January 2017. Applications from primary care practices will be accepted through Sept. 15, 2016.
For more information:
- Comprehensive Primary Care Plus background and details:https://innovation.cms.gov/initiatives/comprehensive-primary-care-plus
- CPC+ FAQ: https://innovation.cms.gov/Files/x/cpcplus-faqs.pdf
- CPC+ one-pager: https://innovation.cms.gov/Files/x/cpcplus-brief.pdf
- Senate Bill 231 Collaborative information: http://www.oregon.gov/oha/Transformation-Center/Pages/SB231-Primary-Care-Payment-Reform-Collaborative.aspx
