Comprehensive Primary Care Plus

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Comprehensive Primary Care Plus

CPC+

CMS’ Comprehensive Primary Care Plus (CPC+) initiative is a voluntary, five-year incentive program built on care management and population health and offered in separate (Track 1/Track 2) levels of reimbursement matched with delivery and health IT functionality requirements.

Both tracks offer PBPM care management and incentive fees. Track 1 follows FFS structures, while Track 2 builds upon Track 1 functionality and doubles the reimbursements and adds bonus funding. (See accompanying resources for CPC+ payment charts.) Delivery is built around five domain categories.

MACRA and MSSP benefits

CPC+ is included within MACRA as an Advanced Alternative Payment Model. This means qualifying practices can achieve MACRA bonus payments and be exempt from the MIPS performance track. Also, practices participating in CMS MSSP ACOs (Tracks 1-3) are dual eligible to participate in CPC+ and receive selected reimbursements from both.

Is my organization eligible for participation?

CMS recently announced the payer regions for CPC+ and practices have until September 15 to apply. Keep in mind; individual practices must have at least 150 Medicare patients. The following regions have been selected, beginning in 2017.

  • Arkansas: Statewide
  • Colorado: Statewide
  • Hawaii: Statewide
  • Kansas and Missouri: Greater KC Area
  • Michigan: Statewide
  • Montana: Statewide
  • New Jersey: Statewide
  • New York: North Hudson-Capital
  • Ohio: Statewide
  • Northern Kentucky
  • Oklahoma: Statewide
  • Oregon: Statewide
  • Pennsylvania: Greater Philadelphia Region
  • Rhode Island: Statewide
  • Tennessee: Statewide

How can Philips Wellcentive help?

Philips Wellcentive has assessed the functionality needed for CPC+ and will support the IT-based workflow requirements. As required for practices pursuing Track 2, Philips Wellcentive has submitted a global letter of support to CMS to cut down on practice paperwork. (Track 2 requires express vendor support, while CPC+ Track 1 does not.) Practices can select either track, but must remain in it during the length of participation.

CPC+ Package

In order to help our customers achieve success in the CPC+ program, we will be providing a specific packaged offering, which includes consulting and new content.

  1. Initial assessment and consulting: help determine which track best aligns with current goals and identify any additional data and/or content needs.
  2. CPC+ measures: access to measures and descriptions for the program, as will be specific in the release of MACRA’s final rule.
  3. Standard content: access to additional content to track progress within program requirements, which will include relevant alerts, reports, care plan templates and assessments.
Core PHM Solutions

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Blog

CPC-Multi-Payer-Regions-blog-thumbailCMS Announces CPC+ Multi-Payer Regions:

This post details the Aug. 1 news on CPC+: payer regions, dual eligibility with MSSPs and the new HCC codes risk model for 2017.

Read blog »

Access these helpful links on CPC+ to learn more.

Tying interventions to outcomes is the goal of PHM platforms. We use Philips Wellcentive to coordinate data and achieve scale across the system and all patients. EMRs can make that connection, but only for individual patients.”

Paula Holmes, Senior Director of Accountable Care, Seattle Children’s

Tying interventions to outcomes is the goal of PHM platforms. We use Philips Wellcentive to coordinate data and achieve scale across the system and all patients. EMRs can make that connection, but only for individual patients.”

Paula Holmes, Senior Director of Accountable Care, Seattle Children’s

Key capabilities

Aggregation

Aggregation

Aggregate and normalize data from multiple clinical and claims systems

Analytics

Analytics

Provide actionable insight for any PHM or VBR program

Action

Action

Proactively improve clinical outcomes and optimize utilization

Accountability

Accountability

Submit data and outcomes directly to CMS and Commercial Payers

 

Disrupting care delivery for the better

Cindy Gaines, Vice President and Chief Operating Officer of Borgess Health, a member of Ascension Health, breaks down how population health has disrupted their care delivery model for the better—and how Philips Wellcentive’s PHM solutions are helping them meet their accountability measures and enhance their patient engagement strategies.

Let’s talk   

What are your biggest challenges in value-based care? Every day, we are helping providers transform the way they deliver care, supporting enhanced patient outcomes and improved use of data. Reach out to us today to learn how you can avoid the cost of inaction and power your success in the new healthcare landscape.

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