On Mar. 19, CMS reported on person-centered primary care initiative.
CMS issued new initiative to increase investments in person-centered primary care.
Payment model for primary care to be tested within Medicare Shared Saving Program.
Aims to improve access to high-quality care for underserved Medicare populations.
Issued accountable care organization (AOC) primary care flex model fact sheet, FAQs.
ACO Primary Care Flex Model
New voluntary model empowers providers in eligible accountable care organizations (ACOs) to treat people with Medicare using innovative, person-centered proactive care.
ACO Primary Care Flex Model (ACO PC Flex Model) provides 1-time advanced shared savings payment and monthly prospective primary care payments (PPCPs) to ACOs.
Savings payments provide ACOs with needed resources and flexibility to cover costs associated with forming an ACO and administrative costs for required model activities.
PPCPs will be distributed by ACOs to primary healthcare practices, giving them improved resources and flexibility to provide care that best suits individuals’ needs.
ACO PC Flex Model designed to incorporate health equity and address care disparities.
Enhanced funding and incentivizes team-based care approaches to medical and social needs, which will create total cost of care savings while preserving/enhancing quality.
Rates for the PPCP will be derived from county-average spending to more accurately reflect the cost of providing comprehensive primary care to underserved populations.
CMS plans to test this new model within the Medicare Shared Savings Program.
Model will focus on, invest in low-revenue ACOs; these historically performed better.
Effectiveness
ACO PC Flex Model is a five-year voluntary model that will begin on Jan. 1, 2025.
Organizations interested in participating must first apply to Shared Savings Program.
Shared Savings Program Applications are open May 20, 2024 - Jun. 17, 2024.
ACO PC Flex Model request for applications is planned to be released in Q2 2024.
