Ohio Comprehensive Primary Care Program

On August 2, 2016, the Governor’s Office of Health Transformation announced details of its Ohio CPC program; a mechanism to support improved population health outcomes in primary care practices. Ohio CPC’s infrastructure is based on the patient-centered medical home model and emphasizes team-based care that is led by a primary care practice that comprehensively manages a patient’s health needs.

The goal of the Ohio CPC program is to empower practices to deliver the best care possible to their patients by improving quality of care and lowering costs.

Ohio CPC practices may be eligible for two payment streams in addition to existing payment arrangements with the Ohio Department of Medicaid and the Medicaid Managed Care Plans:
  • Per-member-per-month (PMPM) payment, to support activities required by the Ohio CPC program
  • Shared savings payment, to reward practices for achieving total cost of care savings.

Additionally, joining the Ohio CPC program gives practices access to data and reports that provide actionable, timely information needed to make better decisions regarding practice outreach, patient care, and community referrals.

In December 2016, 91 out of 150 applicants were been accepted to pilot the Ohio CPC program for a one year demonstration period.

On April 25, 2017, the House Republicans unveiled, in their state budget proposal, the elimination of funding for the Ohio CPC program. The Ohio Academy of Family Physicians worked to having the funding restored, which is primarily federal funding, by appealing to all 33 Ohio Senators and having Randy Wexler, MD, testify before the Senate Finance Health and Medicaid Subcommittee in support of reinstating the funding for Ohio CPC.

In July 2017, the language that would have abolished the Ohio CPC Program was removed from the final version of the bill, however, the budget does not include specific funding for the program. The Ohio CPC program remains a priority for the Kasich administration. The Office of Health Transformation and the Ohio Department of Medicaid (ODM) will assess the Medicaid appropriation deficit in the current budget and evaluate options for the Ohio CPC program going forward, with a goal of extending the pilot and then opening the program to additional practices.

At the end of September 2017, ODM announced its plans to extend the Ohio CPC program into 2018 by invitation only. ODM will be submitting changes to the Ohio Administrative Code Patient-Centered Medical Home Rule to continue with Ohio CPC Program.

Governor’s Office of Health Transformation Resources

Additional Resources