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Capitol Correspondence - 05.04.19

Reminder: CMS Unpacks Its Proposal to Change Fee for Service in Primary Care with a Webinar

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ANCOR is sharing this announcement by the Administration for Community Living (ACL) as a reminder that the Centers for Medicare and Medicaid Services’ (CMS) webinars on changes in Medicare’s primary care fee for service model are fast approaching – one already happened on April 30, the other will be on May 16. As we mentioned last week, this effort could set precedent for such changes to eventually come to Medicaid programs. Programs that support people with disabilities in their daily lives are mostly funded by Medicaid, making this of interest to our membership.

As written by the ACL:

“HHS Secretary Azar and CMS Administrator Verma have announced the CMS Primary Cares Initiative, a new set of payment models that will transform primary care to deliver better value for patients throughout the health care system. Administered through the CMS Innovation Center, the initiative aims to:

  • Provide better alignment for more than 25% of all Medicare FFS beneficiaries
  • Offer new participation and payment options and opportunities for an estimated 25% of primary care practitioners and other health care providers
  • Create new coordinated care opportunities for a large portion of beneficiaries dually eligible for Medicaid managed care and Medicare FFS

Payment model options will support care for patients who have chronic conditions and serious illnesses through two paths:

  • Primary Care First: focuses on access and continuity; care management; comprehensiveness and coordination; patient and caregiver engagement; and planned care and population health
  • Direct Contracting: reduces burden, supports a focus on beneficiaries with complex conditions, and encourages participation from organizations that have not typically participated in Medicare FFS or CMS Innovation Center models

Upcoming CMS Webinars for Stakeholders

Click on a date to register. Note that ACL is also planning a webinar in the next month to share additional details about these new opportunities.