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CPC+ and small practices

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CPC+ and small practices

CPC+ and small practices August 29, 2016

Earlier this year, the Centers for Medicare Medicaid Services (“CMS”) introduced CPC+, their plan to transform primary care by supporting primary care practices that commit to providing comprehensive, coordinated and continuous care for their patients during this 5-year program.
CMS selected the 14 regions that can take part in the program’s inaugural cohort by looking at regions that have demonstrated strong multi-payer support. Given this multi-payer approach, the minimal financial risk for this program, and the strong funding that practices will receive, CPC+ is a program for practices that are looking to invest in practice transformation.

Whether or not you decide to apply and take part in CPC+, primary care will experience significant changes brought about by policy measures such as MACRA. More specifically, starting in 2019, primary care physicians will be paid under two primary payment schemes.

The first, Merit-Based Incentive Payment System (MIPS), administers bonuses or penalties to physicians based on how well they perform relative to their peers on a set of quality and value measures. The second, Alternative Payment Models (APM), offers program-specific payment arrangements and also provides a 5% annual bonus for each of the first 6 years when physicians earn a sufficient portion of revenue through qualifying payment models.

What does this all mean for independent physicians interested in CPC+?

CPC+ provides independent practices with the opportunity to get out of the MIPS “zero-sum game” without having to take on significant financial risk. In addition, practices will have access to that 5% annual bonus for participating in an advanced APM.

Even with these upsides for small practices, in order to participate in CPC+ practices will have to report their progress on practice capabilities regularly through a CMS web portal – similar to how they would if participating in other APM’s or even dealing with MIPS. This reporting requirement will also require significant changes to practice workflows and an initial investment in resources and infrastructure.

Elation is here to support small practices’ unprecedented opportunity to focus on high-quality, comprehensive primary care.

But we also understand the all-too-exhaustive burden of meeting reporting requirements and demonstrating care quality, particularly for small practices.

With this fact in mind, we’re committed to supporting practices participating in CPC+.

We’re doing this by:
• Pledging to support all quality reporting for both Track 1 and Track 2 for the full 5-year duration of the program
• Supporting all required Health IT functionality by January 1, 2019
• Giving you access to CPC+ expertise to guide you through the application process and beyond
• Providing educational resources like our CPC+ Webinar and Reimbursement Guide

Elation has long championed phenomenal patient-centered care, starting with the primary care physician. We believe that as the healthcare industry shifts toward value-based reimbursement, high-quality care will thrive. The CPC+ program is a means for forward-thinking providers to get a step ahead in transforming their practices, and we look forward to supporting those who choose to participate.