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August 22, 2012
500 primary care practices in seven regions
WASHINGTON - The American College of Physicians (ACP) today
praised the Centers for Medicare and Medicaid Services (CMS) for
its announcement of primary care practices to participate in a
historic public-private partnership to strengthen primary care, the
Comprehensive Primary Care Initiative (CPCI).
In support of more effective, affordable, and higher quality
health care, 500 primary care practices in seven regions have been
selected to participate in a new partnership among payers from CMS,
state Medicaid agencies, commercial health plans, self-insured
businesses, and primary care providers. The partnership is designed
to provide improved access to quality health care at lower
"The Administration and the CMS deserve tremendous credit for
advancing this vital initiative, which moves to another critical
stage with today's announcement," said ACP president David L.
Bronson, MD, FACP. "We are extraordinarily pleased with the CPCI's
focus on patient-centered care and practice redesign."
Under the CPCI, CMS will pay primary care practices a care
management fee, initially set at an average of $20 per beneficiary
per month, to support enhanced, coordinated services on behalf of
Medicare fee-for-service beneficiaries. Simultaneously,
participating commercial, state, and other federal insurance plans
are also offering enhanced payment to primary care practices that
are designed to support them in providing high-quality primary care
on behalf of their members.
"The CPCI is an important step in supporting patient-centered
medical homes," said Robert A. Gluckman, MD, FACP, chairman of
ACP's Medical Practice and Quality Committee and chief medical
officer for a participating payer in Oregon. "This program allows
Medicare and private insurers to provide the needed resources so
practices can improve care for all their patients."
For patients, this means these physicians may offer longer and
more flexible hours, use electronic health records; coordinate care
with patients' other health care providers; better engage patients
and caregivers in managing their own care, and provide
individualized, enhanced care for patients living with multiple
chronic diseases and greater needs.
"The CPCI is the kind of common sense investment in health care
we need," said Health and Human Services Secretary Kathleen
Sebelius. "Businesses, families, and taxpayers all benefit from a
stronger primary care system that helps to improve our health and
The initiative started in the fall of 2011 with CMS soliciting a
diverse pool of commercial health plans, state Medicaid agencies,
and self-insured businesses to work alongside Medicare to support
comprehensive primary care. Public and private health plans in
Arkansas, Colorado, New Jersey, Oregon, New York's Capital
District-Hudson Valley region, Ohio and Kentucky's
Cincinnati-Dayton region, and the Greater Tulsa region of Oklahoma
signed letters of intent with CMS to participate in this
initiative. The markets were selected in April 2012 based on the
percentage of the total population covered by payers who expressed
interest in joining the partnership.
Eligible primary care practices in each market were invited to
apply to participate and start delivering enhanced health care
services in the fall of 2012. Through a competitive application
process, primary care practices within the selected markets were
chosen to participate in the CPCI. Practices were chosen based on
their use of health information technology, ability to demonstrate
advanced primary care delivery, service to patients covered by
participating payers, participation in practice transformation and
improvement activities, and diversity of geography, practice size,
and ownership structure. CMS estimates that more than 300,000
Medicare beneficiaries will be served by more than 2,000 providers
through this initiative.
"Primary care practices play a vital role in our health care
system and we are looking at ways to better support them in their
efforts to coordinate care for their patients" said Acting CMS
Administrator Marilyn Tavenner. "By engaging in this unprecedented
and innovative public-private partnership we aim to create a
payment model that allows our primary care practices to take a lead
role in delivering improved overall coordinated care for their
patients. Our goal is to see healthier families across our nation
and to generate savings for providers, insurers and taxpayers."
The American College of Physicians is the
largest medical specialty organization and the second-largest
physician group in the United States. ACP members include 133,000
internal medicine physicians (internists), related subspecialists,
and medical students. Internists specialize in the prevention,
detection, and treatment of illness in adults. Follow ACP on
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