Source: Ohio Governor John Kasich’s Office
Ohio is taking a major step forward in its efforts to create a national model that will reward primary care physicians and other health care professionals who do more to keep patients well and hold down the total cost of care. On August 2, Governor John Kasich announced that in January 2017, Ohio will launch a comprehensive primary care (CPC) program to 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 providers who keep costs low, while at the same time help Ohioans lead healthier lives and keep more money in their pockets,” said Gov. 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 provider 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 Governor’s Office of Health Transformation and the Ohio Department of Medicaid have partnered with Ohio Medicaid’s five managed care organizations, commercial health insurance plans, and primary care practices across the state to implement a CPC program for Ohio that will allow approved primary care practices to earn value-based payments for providing high-quality primary care to patients beginning Sunday, January 1, 2017. The federal Centers for Medicare and Medicaid Services also announced that Medicare will provide enhanced payments for select primary care practices in Ohio through a similar program called Comprehensive Primary Care Plus (CPC+) also beginning Sunday, January 1, 2017. Practices selected for Medicare CPC+ will be invited to join the Ohio CPC program and after Monday, January 1, 2018, any practice that meets the state’s requirements may enroll in the Ohio CPC program.
“This is a key step forward for Ohio to reset the basic rules of health care competition to reward value instead of volume,” said Greg Moody, director of the Governor’s Office of Health Transformation. “Working together, health care payers, providers, and patient advocates set aside competing interests to agree on system changes that have the greatest potential to maintain and improve health while holding down costs. Only through the leadership of Gov. Kasich and the eagerness of Ohio’s health care industry to embrace significant changes to improve primary care has this progress in payment innovation been made possible.”
In 2011, Gov. Kasich charged the Office of Health Care Transformation with bringing together payers, providers and other health care stakeholders to set clear expectations for better health outcomes and improve overall health system performance. To realize these goals, Ohio has utilized federal innovation grant awards of more than $75 million to transform volume-based fee-for-service payments into value-based payments that reward better health outcomes while also holding down the total cost of care.
For more information about CPC+ and to apply, visit the OAFP website.