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Meaningful Health Care Informatics Blog

Jun 10 2012   9:38PM GMT

New Comprehensive Primary Care initiative from CMS to help pay for coordination of care

Posted by: RedaChouffani
Care coordination, CMS, Marilyn Tavenner

CMS announced in a news release on June the 6th, 2012 a new Primary Care initiative that will provide primary care practices a care management fee set at $20 dollars per beneficiary per month.   The proposed fee is designed to support enhanced and coordinated services from CMS and other insurance entities.

This is will be the result of a commitment from 45 commercial, federal and state insurers in seven markets who will work with CMS to provide improved care.

“We know that when we support primary care, we get healthier patients and lower costs,” said Acting CMS Administrator Marilyn Tavenner, “This initiative shows that the public and private sectors can come together to meet the critical need for these services.”


In order for primary care practices to receive this incentive they must offer the following:

  • Flexible hours to see the beneficiaries
  • The use of a certified electronic health records system
  • Delivery of preventative care
  • Coordination of care with patients and other healthcare providers
  • Working with caregivers and patients to engage them
  • Enhancing care for patients living with multiple chronic diseases and higher needs

There will be about 75 practices according to the news release that will be selected to participate in this initiative.   To start a practice must first fill the following application online:

So far several states have payers who have signed an agreement with CMS to participate in this initiative.  The sates are: Arkansas, Colorado, New Jersey, Oregon, New York’s Capital District-Hudson Valley Region, Ohio’s and Kentucky’s Cincinnati-Dayton Region, and greater Tulsa, Oklahoma.

This initiative might provide a great first step for many primary care physicians and practices to move toward the coordination of care and help improve care for high-risk patients and ones with chronic disease.   However the lack of affordable technology components for small primary care physicians that will help with data sharing, patient engagement tools, collaboration and coordination of care might still pose the biggest hurdle for many to overcome.

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