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Primary Care First Model

Sponsor
Centers for Medicare and Medicaid Services
Deadlines
Jan 22, 2020
Contact
Purpose

The Primary Care First Model is a voluntary 5-year payment option that rewards value and quality by offering an innovative payment structure to support delivery of advanced primary care. The model is designed to prioritize the doctor-patient relationship; enhance care for patients with complex chronic needs and high need, seriously ill patients; reduce administrative burden; and focus financial rewards on improved health outcomes.

Eligibility

The Primary Care First payment model option is designed for primary care practices with advanced primary care capabilities that are prepared to accept increased financial risk in exchange for flexibility and potential rewards based on practice performance.

Model Options will be offered in 26 regions for a 2020 start date. A service area map is available on the program website.

Geographic coverage
Nationwide
Amount of funding

Payment will be provided to practices through a simple payment structure, including:

  • A payment mechanism that allows care to be driven by clinicians rather than administrative requirements and revenue cycle management
  • A population-based payment to provide more flexibility in the provision of patient care along with a flat primary care visit fee
  • A performance based adjustment providing an upside of up to 50% of revenue as well as a small downside (10% of revenue) incentive to reduce costs and improve quality, assessed and paid quarterly

Payment options are described in the recorded webinar.

Application process

Visit the program website for links to additional information, recorded webinars, and the application.

Tagged as
Healthcare quality · Medicare · Primary care · Reimbursement and payment models · Service delivery models



For complete information about funding programs, including your application status, please contact funders directly. Summaries are provided for your convenience only. RHIhub does not take part in application processes or monitor application status.