Medicaid Rolls Out Its Ohio CPC Project; 2017 Participants Are By Invitation Only

Ohio Medicaid is rolling out its Ohio comprehensive primary care (CPC) project which will allow the state’s four largest private health insurance plans, along with Medicaid and Medicare, to pay for value rather than volume as part of the ongoing work to improve the health of citizens across the state.

“By working together with our partners in the health care industry, we’ve developed a primary care system that rewards physicians and other health care professionals who keep costs low, while at the same time helps Ohioans lead healthier lives and keeps more money in their pockets,” said Governor John Kasich. “Our new effort will better serve those receiving both public and private care, and can serve as a model for other states to follow.”

The Ohio CPC program is designed to increase access to patient-centered medical homes, a team-based care delivery model led by a primary care physician or other primary care health care professional who comprehensively manages a patient’s health needs with an emphasis on health care value and quality. The goal is to give Ohioans the quality of care and information they need to increase their level of health at every stage of life, and to reduce the overall cost of care by improving cost efficiency and care quality.

The Ohio CPC program in 2017 will involve those practices that meet the following requirements:
  • Practice with 5,000+ Medicaid members and national primary care or patient centered medical home accreditation including NCQA II/III, URAC, Joint Commission, AAAHC; or
  • Practice with 500+ Medicaid members and NCQA III accreditation; or
  • Practice with 500+ Medicaid members and CPC+ participation.

If your practice meets these requirements for participation in Ohio CPC in 2017, you will be notified directly by Ohio Medicaid and will be invited to apply. Eligibility for Ohio CPC practice participation is determined using a provider’s Medicaid billing ID.

In 2018, all practices will be eligible to apply for Ohio CPC.

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