On April 22, the Centers for Medicare and Medicaid Services (CMS) announced the Primary Cares Initiative, a new set of payment models that will transform primary care to deliver better value for patients throughout the healthcare system. Building on the lessons learned from experiences of previous models, such as the Comprehensive Primary Care Plus (CPC+) program, the goal of the CMS Primary Cares Initiative is to reduce administrative burdens and empower primary care physicians and other providers to spend more time caring for patients while reducing overall health care costs.
Administered through the CMS Innovation Center, the CMS Primary Cares Initiative will provide primary care practices and other providers with five new payment model options under two paths: Direct Contracting and Primary Care First.
To explain these two alternative payment models in greater detail and to help physicians grasp CMS’s eligibility requirements so that they can assess whether these payment models align with individual practice goals, the Ohio Academy of Family Physicians (OAFP) enlisted the help of two of its trusted partners at The Health Collaborative to create a 45-minute video. The video details how payments, incentives, and quality strategies align in each of these options. For any physician or practice team that is considering applying for one of these new payment models, watching the following video is highly recommended!
Speaker Biographies
Tiffany Mattingly is the clinical quality improvement director for The Health Collaborative and has over 15 years of health sector leadership including clinical expertise with special focus on maternal and newborn health. She’s led diverse, interdisciplinary teams in the acute hospital setting, and has executed clinical quality improvement projects using Lean, IHI, and proven evidence-based quality improvement methodologies.
Ms. Mattingly is responsible for the strategy and execution of the largest payment demonstration project launched by the Centers for Medicare and Medicaid Innovation. In her role at The Health Collaborative, she helps lead the 560 primary care practice teams of Ohio/Northern Kentucky through the CPC+ program.
In addition to her many volunteer efforts, Ms. Mattingly serves on the Mental Health Recovery Services Board for Warren and Clinton counties and is a member of the Ohio Organization of Nurse Executives. She holds a master’s and bachelor’s degree in nursing from the University of Cincinnati (UC).
Barbara Tobias, MD, who served as our question facilitator, is a family physician and interim chair of the Department of Family and Community Medicine at the UC College of Medicine. She is also the Robert and Myfanwy Smith Professor of Family Medicine. Dr. Tobias was a 2009-10 Robert Wood Johnson Health Policy Fellow in the Immediate Office of the Secretary at the U.S. Department of Health and Human Services.
Dr. Tobias serves as the medical director of The Health Collaborative, providing leadership and support to physicians and practices in public reporting, payment reform, quality improvement, population health, and practice transformation initiatives including the CPC Classic project, CPC+, and the Accountable Health Communities initiative.
Dr. Tobias is a graduate of the UC College of Medicine and received her Bachelor of Arts from Cornell University. She has practiced family medicine for over 25 years. Dr. Tobias is a member of the OAFP and has served in various leadership roles during her tenure.
Dr. Tobias and Ms. Mattingly provide expert leadership throughout the video and do an exceptional job in making a complex issue more easily understood.
Additional information about the CMS Primary Cares Initiative is available on the OAFP website.
Questions? You have a whole team of people here to support you.
Please contact Ms. Mattingly at The Health Collaborative; Kate Freeman, MPH, care delivery and payment strategist at the American Academy of Family Physicians; or Kate Mahler, CAE, deputy executive vice president of the OAFP.
It seems to be that Primary Care First really has NO downside risk for any FM Doc. When they talked about risk it is not a “financial pay back” as some of us have seen in our past.
Another simple question is why hasn’t this information been shared in many ways to our OAFP members particularly the independent practices as they are simply missing out on receiving funds that would help their businesses? Those who are employed have COOs who are keeping them informed.