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Life Health > Long-Term Care Planning

PPACA: HHS Seeks Carriers for Primary Care Investment Project

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The U.S. Department of Health and Human Services (HHS) wants to try teaming up with public and private health plans to invest in modernizing primary care medical practices.

HHS has issued a solicitation for a new, 4-year Comprehensive Primary Care (CPC) demonstration project.

Officials are trying to set up CPC program tests in 5 to 7 communities, with about 75 primary care practices participating in each community.

HHS is hoping to find carriers willing to work with it and one another to help primary care practices put more energy into managing the care of high-risk patients; promoting easy access to care and continuity of care; improving planning for preventive care and for care for chronic conditions; promoting patient and caregiver engagement; and coordinating care.

The Centers for Medicare and Medicaid Services (CMS) would chip in and provide a monthly care management fee for the Medicare enrollees a practice serves. After the program was in place for a year, practices also would share in any Medicare savings resulting from the program.

Other carriers participating in the program also would compensate the primary care practices, officials say.

HHS is trying the CPC approach because big employers and large commercial insurers seem to be getting good results from similar test projects, officials say.

“We know that when doctors have time to spend time with their patients and can better coordinate care with specialists, people are healthier and we have lower costs in the health care system,” CMS Administrator Donald Berwick says in a statement about the test program.

HHS is developing the test program to implement Section 3021 of the Patient Protection and Affordable Care Act of 2010 (PPACA), which calls for HHS to test new payment and care delivery strategies that might increase the quality of care while reducing the cost.

The CPC project is comparable to but separate from the widely publicized accountable care organization (ACO) projects, officials say.

A nonbinding letter of intent is due Nov. 15.

Final applications are due Jan. 17, 2012.

Other primary care reimbursement coverage from National Underwriter Life & Health:


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