4 Ways New CMS Primary Care Program Will Help Doctors to Better Coordinate Care

Thursday, September 29th, 2011
This post was written by Patricia Donovan

To help primary care doctors better coordinate care for Medicare patients, CMS is taking a page from large private payors’ care coordination programs. The Medicare Comprehensive Primary Care program announced this week will work with commercial and state health insurance plans to offer additional support to primary care doctors who better coordinate care for Medicare beneficiaries in order to deliver higher quality and more patient-centered care.

This collaboration is modeled after innovative practices developed by large employers and leading private health insurers in the private sector.

This support will help doctors in the following five areas:

  • Help patients with serious or chronic diseases follow personalized care plans;
  • Give patients 24-hour access to care and health information;
  • Deliver preventive care;
  • Engage patients and their families in their own care;
  • Work together with other doctors, including specialists, to provide better coordinated care.

The voluntary initiative will begin as a demonstration project in five to seven healthcare markets across the country. Interested public and private healthcare payors must submit a letter of intent by November 15, 2011. In the selected markets, Medicare and its partners will enroll interested primary care providers into the initiative.

CMS will pay primary care practices a monthly fee for these activities in addition to the usual Medicare fees that these practices would receive for delivering Medicare covered services. According to the HHS, this collaborative approach has the potential to strengthen the U.S. primary care system and reduce healthcare costs by using resources more wisely and preventing disease before it happens.

Across the country, systems based on comprehensive, higher-functioning primary care show that patients are healthier and avoid having to seek care in more complex and expensive settings when primary care practices have the resources to better coordinate care, engage patients in their care plan, and provide timely preventive care. Large businesses have been able to make independent investments to promote more comprehensive primary care – improving the health of their employees and lowering their healthcare costs, thus making it easier for them to hire more workers and invest in their workforce.

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