decisionhealth Newsletters, Part B News - 2012 Issue 6 (June)
Primary care practices in 8 states: Bonuses under new CMS initiative could up revenue
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Article Overview
This article covers CMS’s Comprehensive Primary Care Initiative (CPCI) and explains which primary care practices may be eligible to participate, where the initiative is available, and how the application process works. It is relevant to primary care administrators, practice managers, and coding/billing professionals who track federal payment initiatives, practice transformation requirements, and revenue impact considerations. The article also discusses the types of practice capabilities CMS is looking for and the general payment structure associated with the program.
Why This Topic Matters
It helps practices quickly assess whether they may qualify for a CMS primary care payment initiative and understand the operational areas CMS is emphasizing. It also provides context for evaluating potential revenue impact and readiness for participation.
Article Sections
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Primary care
Overview of the initiative, participating states and regions, and the general eligibility focus for primary care practices.
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What CMS is looking for in participating practices
Broad characteristics CMS uses when evaluating practices, including care coordination, patient access, preventive care, and health information technology use.
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Tips to determine whether your practice fits the profile
Practical considerations for assessing readiness and whether existing practice efforts align with the initiative’s overall expectations.
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Example: GreenField Health System
An illustrative practice profile showing the kinds of operational and technology-related features described in connection with the initiative.
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Estimating financial impact
General guidance on considering the possible revenue effect of participation and monitoring payer announcements in the listed regions.
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What happens once you apply to CPCI
A summary of the application workflow, timing, selection process, and the overall structure of the payment arrangement.
What You Will Learn
- What the Comprehensive Primary Care Initiative is and who it is intended for
- Which geographic areas were included in the initial initiative
- What general practice capabilities CMS emphasized for participation
- How the application and selection process was described
- What types of financial and operational factors practices were encouraged to evaluate
Who Should Read This
- Primary care practices
- Practice administrators
- Medical billing and coding professionals
- Healthcare revenue cycle staff
- Family medicine and internal medicine organizations
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