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Overview of Comprehensive Primary Care initiative.

Hilarie Houghton

on 21 March 2013

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Transcript of CPCi

Region Transform
health care
at the point of delivery Enhanced risk-stratified, non-visit based payment system
Shared savings program
Systematic data sharing
Ongoing education CMS'
program milestones MyHealth Value-Based Care Models Multiple Goal: Access Provider Support Intensive Medical Homes Better health.
Better care.
Lower costs. Comprehensive
Primary Care
initiative Seven regions
selected across
the nation Risk stratify population and provide care management for
high-risk patients A four-year initiative developed by CMS Innovation Center; a collaboration between multi-payers that seeks to stengthen free-standing primary care capacity by testing a model of comprehensive, accountable primary care. Definition: Network Non-profit coalition that helps doctors deliver safer and more efficient health care through the secure sharing of medical records. Beacon Community Award Winner Extended Medical Homes CPCi FEP ASO Future
engagement Community
Care Oklahoma Health Care Authority CMS Payers Provider Income Year 1 Use data to improve care at the provider/ care team level Assess and improve the patient experience of care Provide 24/7 patient access guided by the medical record Demonstrate active engagement and care coordination across the medical neighborhood Improve patient shared decision-making capacity Participate in the market-based learning community Attest to the requirements for Stage 1 Meaningful Use Create an annual budget/forecast for spending CPCi funds No Medicare supplement members. 9.8% of our 18,000 participating members are Tier 1 Medicaid members included. Primary care physicians Patients
of all ages Value-based
reimbursement 18,000 members Eligibility Does not include Illinois, Texas and New Mexico plan members. BCBSOK fully-insured members only Tier 1: High risk, high opportunity HCSC employees per member, per month Shared savings
start after Year 2. $ Business perspective: ADVANTAGE MARKET POWER
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