The U.S. Department of Health and Human Services (HHS) on Wednesday launched a new initiative whereby Medicare will work with commercial and state health insurance plans to offer additional support to primary care doctors aimed at improving care coordination for patients.
Called the Comprehensive Primary Care initiative, the program will start as a demonstration project in five to seven markets across the country and is a program of the Center for Medicare and Medicaid Innovation (CMMI), which is a part of the Centers for Medicare & Medicaid Services. It is modeled after innovative practices developed by large employers and leading private health insurers in the private sector.
Primary care practices that choose to participate in the initiative will be given support to better coordinate primary care for their Medicare patients.
This support will help doctors:
- Help patients with serious or chronic diseases follow personalized care plans;
- Give patients 24-hour access to care and health information;
- Deliver preventive care;
- Engage patients and their families in their own care;
- Work together with other doctors, including specialists, to provide better coordinated care.
"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," said CMS Administrator Donald Berwick, MD, in a press release announcing the initiative.
Under the demonstration project, CMS hopes to aid doctors by replicating proven methods currently employed by large medical systems and large employers that have placed added emphasis on comprehensive models of primary care. These efforts typically show better care coordination, engage patients in their care plan and provide timely preventive care.
The overarching goal is to both improve patient health, while also lessening the need for patients to seek more complex and expensive care.
The announcement received broad statements of support from across the industry.
"We're confident this initiative will further demonstrate that patient outcomes improve and costs are saved when the healthcare system values primary care by paying for all the services family physicians provide to their patients," said Glen Stream, MD, MBI president of the American Academy of Family Physicians. "And we're pleased that the secretary of the Department of Health and Human Services has the authority to expand this program once the results of this initiative are in."
Under the demonstration, CMS will apply a bundled payment approach for primary care – paying primary care practices a monthly fee for higher levels of primary care in addition to the usual Medicare fees practices normally receive for delivering Medicare-covered services.
"Physicians want to deliver coordinated, cost-effective care that improves patient outcomes, but the current payment system often penalizes the valuable services that make these improvements possible," said Peter W. Carmel, MD, president of the American Medical Association in a prepared statement. "By providing a monthly care management fee for Medicare patients, CMMI is recognizing the full scope of work done by physician practices to improve the health of their patients. Participation by private health insurers will strengthen the reach and success of the program."
Public and private healthcare payers interested in applying to participate in the Comprehensive Primary Care Initiative must submit a Letter of Intent by Nov. 15, 2011. In the selected markets, Medicare and its partners will enroll interested primary care providers into the initiative.