On April 22, 2019, in a conference room in Washington DC, HCCI’s CEO Dr. Tom Cornwell, MD, AAHCM President Eric De Jonge, MD, and a small crowd of stakeholders were invited along with members of the press to hear an announcement which house call providers have been working toward and anticipating for more than 15 years. Alex Azar, Secretary of the U.S. Department of Health and Human Services along with Seema Verna, Administrator of the Centers for Medicare & Medicaid Services (CMS), and Adam Boehler, CMMI Senior Advisor to the Secretary announced the revolutionary “CMS Primary Cares” initiative to empower patients and providers to drive better value and results.

Below HCCI has gathered and consolidated a wealth of information to help you learn about these groundbreaking new payment models and their benefit to your home-based primary care practice.

HCCI Press Statement

Payment Reform Paves the way for Expanding Home-Based Primary Care

The field of home-based primary care (HBPC) received extraordinary news as the US Department of Health and Human Services (HHS), in collaboration with the Centers for Medicare and Medicaid Services (CMS) and the Center for Medicare and Medicaid Innovation (CMMI), announced its groundbreaking CMS Primary Cares initiative in Washington, D.C.

CMS Primary Cares aims to improve quality, improve patient experience of care, and reduce expenditures by increasing patient access to advanced primary care services. This revolutionary payment model includes several elements specifically designed to support practices caring for patients with complex chronic needs or serious illness, the patient population that can benefit so dramatically from home-based primary care. Read the full press release

AAHCM Press Statement

AAHCM Supports New CMMI Payment Models that Strengthen Primary Care for People with Complex Chronic Illness

The American Academy of Home Care Medicine (AAHCM) strongly supports the CMS announcement today of the Primary Cares Initiative, which offers two new payment paths to promote primary care of Medicare patients with complex, advanced illness. “The Primary Cares Initiative offers upfront payment incentives to serve Medicare populations with complex medical and social needs. The two options, Primary Care First (PCF) and Direct Contracting (DC), offer enhanced payment for Home-Based Primary Care and other providers to care for people with advanced illness,” said Eric De Jonge, MD, President, AAHCM. Read the full press release

AAHCM APM Overview

New CMMI Models Announced to Support Primary Care for People with Complex Chronic Illness

The Academy is pleased to share initial details on two new Alternative Payment Models (APMs) that promote primary care of Medicare beneficiaries with complex, advanced illness. The high-level outlines of these new APMs were announced on April 22 by the Center for Medicare and Medicaid Innovation (CMMI). These APMs are part of a new CMS Primary Cares Initiative and will offer a choice of two new payment paths. The new payment demonstrations are meant to promote value-based care, with a voluntary shift of up to 25 percent of primary care Medicare fee-for-service patients to these new models. This e-alert summarizes the information CMS has released to date about the models.  Several important details, such as exact payment amounts and patient eligibility criteria, remain to be announced. We will issue additional alerts to Academy members as soon as information is made available in the coming weeks. Read the full article

HHS Secretary Azar’s Announcement (Speech)

Good afternoon, everyone, and thank you so much for joining us. Thank you in particular to the American Medical Association for inviting us here to announce today’s news.

It’s appropriate to be at the headquarters of an organization with such a long history in American medicine, because I believe we’ll look back at what we’re announcing today as a historic turning point in American healthcare.

Today’s announcement is the culmination of years of work by many at HHS and throughout American healthcare. Read Secretary Azar’s full speech

CMS Overview of the new Payment Models

HHS To Deliver Value-Based Transformation in Primary Care

Today, U.S. Department of Health and Human Services (HHS) Secretary Alex Azar and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma are announcing the CMS Primary Cares Initiative, a new set of payment models that will transform primary care to deliver better value for patients throughout the healthcare system. Building on the lessons learned from and experiences of the previous models, the CMS Primary Cares Initiative will reduce administrative burdens and empower primary care providers to spend more time caring for patients while reducing overall health care costs. The models were developed by the Innovation Center under the leadership of Adam Boehler and are part of Secretary Azar’s value-based transformation initiative. Read the full statement

CMS Details on Primary Care First

Primary Care First: Foster Independence, Reward Outcomes

Primary Care First is a set of voluntary five-year payment model options that reward value and quality by offering innovative payment model structures to support delivery of advanced primary care. In response to input from primary care clinician stakeholders, Primary Care First is based on the underlying principles of the existing CPC+ model design: prioritizing the doctor-patient relationship; enhancing care for patients with complex chronic needs and high need, seriously ill patients, reducing administrative burden, and focusing financial rewards on improved health outcomes. Read the CMS fact sheet

CMS Details on Direct Contracting

Direct Contracting

Direct Contracting (DC) is a set of voluntary payment model options aimed at reducing expenditures and preserving or enhancing quality of care for beneficiaries in Medicare fee-for-service (FFS). The payment model options available under DC create opportunities for a broad range of organizations to participate with the Centers for Medicare & Medicaid Services (CMS) in testing the next evolution of risk-sharing arrangements to produce value and high quality health care. Building on lessons learned from initiatives involving Medicare Accountable Care Organizations (ACOs), such as the Medicare Shared Savings Program (MSSP) and the Next Generation ACO (NGACO) Model, the payment model options available under DC also leverage innovative approaches from Medicare Advantage (MA) and private sector risk-sharing arrangements. Read the CMS fact sheet