Comprehensive Primary Care Plus

On August 1, 2016, the Centers for Medicare & Medicaid Services (CMS) announced that the entire state of Ohio and several northern Kentucky counties had been selected as a region to participate in Comprehensive Primary Care Plus (CPC+), a national advanced primary care medical home model that aims to strengthen primary care through a regionally-based multi-payer payment reform and care delivery transformation. Ohio is the largest region chosen to participate with 562 practice sites along with the largest number of providers, 2,566, participating in the program.

CPC+, a five-year model that began in January 2017, includes two primary care practice tracks with incrementally advanced care delivery requirements and payment options to meet the diverse needs of primary care practices in the United States. The care delivery redesign ensures practices in each track have the infrastructure to deliver better care to result in a healthier patient population. The multi-payer payment redesign will give practices greater financial resources and flexibility to make appropriate investments to improve the quality and efficiency of care, and reduce unnecessary health care utilization. CPC+ will provide practices with a robust learning system, as well as actionable patient-level cost and utilization data feedback, to guide their decision making.

The following video presentation was recorded on August 13, 2016, at the Ohio Academy of Family Physicians Members Assembly. American Academy of Family Physicians Senior Vice President for Advocacy, Practice Advancement, and Policy Shawn Martin provided an overview of MACRA and CPC+. To view the CPC+ portion of the presentation, please advance to minute 41.42.

Key Functions

The goal of CPC+ is to improve the quality of care patients receive, improve patients’ health, and spend health care dollars more wisely. Practices in both tracks will make changes in the way they deliver care, centered on key Comprehensive Primary Care functions: (1) access and continuity; (2) care management; (3) comprehensiveness and coordination; (4) patient and caregiver engagement; and (5) planned care and population health. In addition to Ohio and northern Kentucky, 13 other CPC+ regions were selected. View additional information about each CPC+ region and the payers.

Ohio’s Medicaid CPC Program

On August 2, 2016, the Governor’s Office of Health Transformation announced details of its CPC program. In December 2016, 91 practices had been accepted for the 2017 Ohio CPC program out of 150 applicants.

AAFP Resources

Additional Resources