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Advanced Alternative Payment Models Part III: Understanding Comprehensive Primary Care Plus

Advanced Alternative Payment Models Part III: Understanding Comprehensive Primary Care Plus


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Richard Hayden Self, MD, MBA, and Janis Coffin, DO, FAAFP, FACMPE
 
With CMS establishing preliminary definitions for fully qualifying Advanced Alternative Payment Models (APMs) in May 2016, many care providers accepting Medicare and Medicaid payments will need to understand the nature of these entities if they wish to eventually participate in one of the current or future payment models. Changes under the Medicare Access and CHIP Reauthorization Act of 2015 specifically identify subsets of APMs that allow providers to avoid possible negative adjustments for poor relative performance compared with their respective peer groups through the Merit-Based Incentive Payment System beginning in 2017. This article reviews the nature of one of the fully qualifying Advanced APMs, the Comprehensive Primary Care Plus Model, and its advanced medical home model based on previous experience with the prior Comprehensive Primary Care program. This model represents a more sophisticated option for organizations with significant medical home experience in select participating states seeking an advanced APM for the 2018 reporting period and beyond.