E/M Coding Alert - 2019 Issue 10
Reimbursement: CMS Bolsters Primary Care With New Payment Models
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Article Overview
This article explains how CMS is reshaping Medicare reimbursement through new primary care-focused payment models. It discusses the overall initiative, the two main pathways, participation timelines, and the broader shift toward value-based care. The piece is aimed at providers, practice leaders, compliance professionals, and reimbursement stakeholders who need to understand upcoming Medicare model changes and their operational implications.
Why This Topic Matters
CMS payment model changes can affect how primary care organizations participate in Medicare, manage financial risk, and prepare for new performance periods. Understanding the scope and timing of these initiatives helps practices and related organizations plan for reimbursement and care delivery changes.
What You Will Learn
- The purpose and direction of CMS’s Primary Care Initiative
- How the initiative is organized into two main pathways
- The types of organizations and practices affected by the new models
- How the rollout timeline differs between participation and performance periods
- How the policy shift fits into broader Medicare value-based payment trends
Who Should Read This
- Primary care physicians
- Medical practice administrators
- Compliance professionals
- Reimbursement specialists
- Healthcare policy analysts
- ACO and value-based care stakeholders
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