Comprehensive Primary Care Plus (CPC+) is a national advanced primary care medical home model that aims to strengthen primary care through regionally-based multi-payer payment reform and care delivery transformation. CPC+ includes two primary care practice tracks with incrementally advanced care delivery requirements and payment options to meet the diverse needs of primary care practices in the United States (U.S.).
- Louisiana: Statewide
- Nebraska: Statewide
- North Dakota: Statewide
- New York: Greater Buffalo Region (Erie and Niagara Counties)
CPC+ is a unique public-private partnership, in which practices are supported by 54 aligned payers in 14 regions (PDF) in Round 1, and seven payers in four regions (PDF) in CPC+ Round 2. This partnership gives practices additional financial resources and flexibility to make investments, improve quality of care, and reduce the number of unnecessary services their patients receive.
CPC+ provides practices with a robust learning system, as well as actionable data feedback to guide their decision making. The care delivery redesign ensures practices have the infrastructure to deliver better care, resulting in a healthier patient population.
CPC+ Round 1 supports 2,850 primary care practices, comprising 13,090 clinicians and serving more than 1.76 million Medicare beneficiaries. Practices of all sizes and structures are located in each of the 14 CPC+ regions: Arkansas, Colorado, Hawaii, Greater Kansas City Region of Kansas and Missouri, Michigan, Montana, North Hudson-Capital Region of New York, New Jersey, Ohio and Northern Kentucky Region, Oklahoma, Oregon, Greater Philadelphia Region of Pennsylvania, Rhode Island, and Tennessee.
CMS expects to select up to 1,000 primary care practices in CPC+ Round 2: Louisiana, Nebraska, North Dakota, and the Greater Buffalo Region of New York.
CPC+ seeks to improve quality, access, and efficiency of primary care. Practices in both tracks will make changes in the way they deliver care, centered on key Comprehensive Primary Care Functions: (1) Access and Continuity; (2) Care Management; (3) Comprehensiveness and Coordination; (4) Patient and Caregiver Engagement; and (5) Planned Care and Population Health.
To support the delivery of comprehensive primary care, CPC+ includes three payment elements:
- Care Management Fee (CMF): Both tracks provide a non-visit-based CMF paid per-beneficiary-per month (PBPM). The amount is risk-adjusted for each practice to account for the intensity of care management services required for the practice’s specific population. The Medicare fee-for-service (FFS) CMFs will be paid to the practice on a quarterly basis.
- Performance-Based Incentive Payment: CPC+ will prospectively pay and retrospectively reconcile a performance-based incentive based on how well the practice performs on patient experience measures, clinical quality measures, and utilization measures that drive total cost of care.
- Payment under the Medicare Physician Fee Schedule: Track 1 continues to bill and receive payment from Medicare FFS as usual. Track 2 practices also continue to bill as usual, but the FFS payment will be reduced to account for CMS shifting a portion of Medicare FFS payments into Comprehensive Primary Care Payments (CPCP), which will be paid in a lump sum on a quarterly basis absent a claim. Given our expectations that Track 2 practices will increase the comprehensiveness of care delivered, the CPCP amounts will be larger than the FFS payment amounts they are intended to replace.
Practice and Payer Selection
The solicitations for payers and practices to partner in CPC+ Round 2 are now closed. For questions about the model or the solicitation process, please email CPCplusapply@telligen.com or call the CPC+ Application Support Team at 1-877-309-6114.
- There are seven payers in four regions that will support CPC+ Round 2 practices (PDF).
- There are five additional payers (PDF)—three existing Round 1 payer partners and two new payer partners— that will be providing additional multi-payer support in six CPC+ Round 1 regions.
- CPC+ Round 2 practice applicants will be notified of their selection in Fall 2017, and a list of CPC+ Round 2 participating practices will be available in early 2018.
- CPC+ Request for Applications (PDF)
- CPC+ Round 1 Payer and Region List (PDF) | CPC+ Round 2 Region and Payer List (PDF)
- CPC+ Round 1 Practice Participant List
- CPC+ Payment Methodology Paper (PDF)
- CPC+ In Brief (PDF)
- CPC+ Payment Innovations Brief and Case Studies (PDF) | CPC+ Payment Innovations Video
- CPC+ Care Delivery Transformation Brief (PDF) | CPC+ Care Delivery Transformation Video
Information for Practices
- CPC+ Practice Slide Presentation (PDF)
- CPC+ Practice Frequently Asked Questions (PDF)
- CPC+ Practice Care Delivery Requirements (PDF) | CPC+ Behavioral Health Integration Menu of Options (PDF)
- Health IT Vendors Supporting CPC+ (PDF)
- CPC+ Health IT Vendor Global Letters of Support (PDF)
- CPC+ Quality Reporting Overview PY 2017 (PDF) | CPC+ Quality Reporting Overview PY 2018 (PDF)
Information for Payers
- CPC+ Payer Memorandum of Understanding (PDF)
- CPC+ Payer Frequently Asked Questions (PDF)
- CPC+ Payer Fact Sheet (PDF)
Information for Health IT Vendors
- CPC+ Health IT Vendor Memorandum of Understanding (PDF)
- CPC+ Health IT and Track 2 Requirements (PDF)
- CPC+ Health IT Vendor Global Letter of Support Template (PDF)
- CPC+ Health IT Vendor Letter of Support Template (PDF)
- CPC+ Round 1 Practice Participant Press Release
- CPC+ Round 2 Press Release (December 15, 2016)
- CPC+ Press Release | CPC+ Regions Announcement Press Release | CPC+ Regions Announcement Fact Sheet
- 2018 Payer & Practice Solicitation Fact Sheet | CPC+ Regions Announcement Fact Sheet
- JAMA article: "Medicare's Vision for Advanced Primary Care: New Directions for Care Delivery and Payment" (April 11, 2016)
- CPC+ Archived Materials