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Primary Care on Steroids

Joy greeted yesterday’s CMS announcement that 500 practices have been enrolled in a new public-private initiative to support the nation’s struggling primary care physicians. That was the reaction, anyway, of Pamela Coyle-Toerner, CEO and President of Queen City Physicians in Cincinnati, one of many Allscripts EHR clients to be selected for the program.

“It’s fun to see primary care providers getting the attention and respect they deserve,” Coyle-Toerner told It Takes A Community. “The government gets it, now we need the rest of the care community to get it. … We’re trying to make sure that primary care survives as a profession.  These providers can truly help us, as a country, survive the cost crisis that we have.”

CMS seems to agree.

The Comprehensive Primary Care initiative (CPC) is the latest in a series of federal efforts to reinvigorate primary care as a specialty. It’s increasingly clear that only PCPs can deliver the care coordination that’s critical to the success of health reform in general. CMS apparently hopes the new program will both encourage medical school residents to explore primary care, and dissuade PCPs from retiring early.

If it works as planned, the program will increase reimbursement for participating PCPs, who rank at the bottom of every physician salary survey.  Participating practices will share savings (profits) with the many private payers who’ve agreed to take part in the initiative. 

Here’s a portion of the letter that CMS sent to the selected practices:

“As a participant in CPC, [payers] have committed to offer CPC-selected practices enhanced payments (commonly a monthly care management fee) for their members attributed to your practice and an opportunity to earn shared savings. In the coming weeks, you will have the opportunity to enter into separate agreements with these payers.

“These enhanced revenue streams are intended to support your practice’s transformation. Over the 4 years of the Initiative, we hope these enhanced revenue streams will assist your practice in efficiently and effectively allocating resources, coordinating care, interacting with the medical neighborhood, and leveraging health IT in the pursuit of better care and better health for your patients and lower system-wide costs. In addition to financial support, your practice will receive substantial resources to inform your transformation, including regular market-wide learning collaboratives, a CMS-supported learning portal, and a targeted educational curriculum.”

Coyle-Toerner was excited both by the promise of support and the reimbursement plan, which she said will build upon Queen City’s existing Patient Centered Medical Home agreements with regional payers.

“This is taking care in the primary care setting and putting it on steroids,” she said.  “Building enhanced tools and patient engagement is not something we can easily do on our own but we can do it with help from others. This is a game changer for us.”

We hope it’s a game changer for the industry, as well.

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