Reimbursement: Get Ready: New Alternative Payment Model Promises to Transform Primary Care

Why This Topic Matters

The article helps readers understand a major Medicare primary care payment initiative and the operational choices it may create for practices, especially those already involved in ACOs or considering MSSP participation.

Article Sections

1. CMS Makes a Bold Move with New Model

   Introduces the new CMS primary care initiative and places it in the context of earlier Medicare primary care payment efforts. It also notes the model’s scale and duration.

2. CPC+ Offers Up-Front Incentives

   Summarizes the model’s intended focus on care improvement, patient engagement, coordination, and support for practices across the two tracks. It also describes the general nature of the upfront incentive structure.

3. Understand the Payment Structure

   Describes the broad payment approach for each track and contrasts the treatment of routine fee-for-service payments with the model’s alternative payment elements. It also notes that performance affects whether certain upfront amounts are retained or repaid.

4. You Have a Tough Choice to Make

   Explains the participation conflict between the new model and the Medicare Shared Savings Program and discusses the potential implications for ACOs. It highlights the strategic decision faced by practices and organizations.

5. Pay Attention to Model’s Timing

   Outlines the general application and selection timeline for the initiative and notes when the program is expected to begin. It also addresses how timing uncertainty may influence practice and payer planning.