CMS has introduced a new voluntary payment model called Primary Care First, which is focused on improving primary care by testing the new payment model in select ‘regions’ throughout the country. Primary Care First is slated to begin in 26 regions in 2020. The regions include: Alaska (statewide), Arkansas (statewide), California (statewide), Colorado (statewide), Delaware (statewide), Florida (statewide), Greater Buffalo region (New York), Greater Kansas City region (Kansas and Missouri), Greater Philadelphia region (Pennsylvania), Hawaii (statewide), Louisiana (statewide), Maine (statewide), Massachusetts (statewide), Michigan (statewide), Montana (statewide), Nebraska (statewide), New Hampshire (statewide), New Jersey (statewide), North Dakota (statewide), North Hudson-Capital region (New York), Ohio and Northern Kentucky region (statewide in Ohio and partial state in Kentucky), Oklahoma (statewide), Oregon (statewide), Rhode Island (statewide), Tennessee (statewide), and Virginia (statewide).
The overall objective of this payment model is to see if an emphasis on primary care can reduce overall patient costs. This allows provides to care for seriously ill Medicare beneficiaries who do not have a primary care provider. CMS hopes to reduce administrative burden for participating providers so that they have more time to spend caring for patients.
The payment model takes a multi-payer approach in hopes to support independence and flexibility for primary care providers. CMS hopes that this will allow providers the ability to innovate and improve their care delivery approach by rewarding participating providers with increased reimbursements for meeting a set of clinical quality and patient experience measures.
As with most of CMS’ other payment models recently, the ultimate goal is to reduce costs and administrative burden, allowing more time with patients and improved quality of care.
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