CMS Updates on Payment Models

The Centers for Medicare & Medicaid Services (CMS) is currently accepting applications for Cohort 2 of practices and payer partners interested in participating in the Primary Care First model. To be responsive to stakeholder’s needs and allow more practices the opportunity to apply, CMS has extended the deadline for applications. The deadline for PCF practice applications has been extended to May 21, 2021, and the deadline for payer applications has been extended to June 18, 2021. This is for the Primary Care First general track; CMS is not currently soliciting applications for another PCF Seriously Ill Population (SIP) cohort currently.

PCF offers the opportunity for practices to begin transforming into a value-based care payment structure. Practices are reimbursed a capitated payment amount for their attributed population in addition to a flat visit fee and the opportunity for a quarterly performance-based adjustment bonus which can potentially be up to 50% more revenue than traditional Fee-for-Service (FFS). To learn more, review the valuable materials and past webinars available on the CMS PCF Model Options Webpage and apply here on the application portal.

The Center for Medicare and Medicaid Innovation (CMMI) recently announced that they would not be soliciting a second round of applications for the Global and Professional Direct Contracting Model (GPDC). CMMI reiterated the commitment to value-based care and is currently reviewing its portfolio and learnings from this model to inform next steps and strategies. There are still 53 organizations participating in the GPDC model for the performance year 2021, which started on April 1, 2021. CMS published the participant list for those organizations currently participating. We encourage practices to review participating organizations and payers in their region to explore any partnership opportunities.