The Health Collaborative, located in Cincinnati, OH, was selected by the Center for Medicare and Medicaid Innovation (CMMI) and the Learning Infusion Leader of the 562 primary care practices (more than 2,500 physicians and providers) selected to implement major changes in patient care coordination.
The practices, located throughout Ohio and Northern Kentucky, were selected to participate in a project known as Comprehensive Primary Care Plus (CPC+). A team of practice support professionals at The Health Collaborative will offer group learning, individual coaching, and technical assistance to help practices successfully meet the expectations and goals of the CPC+ program.
CPC+ is a partnership among Medicare, Medicaid, six Medicaid managed care companies, five commercial insurers, and care providers in the region. These payers have agreed to invest in the selected practices by paying monthly care management fees, which the practices use to improve the coordination of patient care. The fee allows the care team to offer services to patients that are not billable under traditional fee-for-service payment models. Examples include more comprehensive chronic disease management, self-care coaching, support after a hospital discharge, expanded and non-traditional access to care, and other services to keep patients as healthy as possible between visits to the doctor.
Ohio/Northern Kentucky is one of 14 regions selected to participate in CPC+. Practices are required to join the Regional Practice Network and take part in regularly scheduled learning sessions, share best practices, and submit data to document their progress in improving quality and lowering overall cost of care through prevention of potentially avoidable acute episodes.
From 2012-16, Greater Cincinnati was one of seven regions selected by CMMI for a demonstration pilot, now known as CPC classic. The Health Collaborative helped lead a group of just 75 practices through a similar program to CPC+. The positive outcomes from that pilot resulted in the expansion throughout Ohio. By the end of the program, practices had reduced emergency department visits by 2.8% and reduced hospital bed days by 17.8%. Perhaps most significant was the 23% reduction in hospitalization for patients who have chronic conditions such as diabetes and heart disease, for which hospitalization can be avoided if the patient and doctor are able to closely monitor symptoms, medications, diet, and exercise.
CPC classic ran from October 2012 through December 2016 and focused mainly on activities promoting population health management. CPC+ is a similar approach, putting more primary care practices at the epicenter of patient-focused quality improvement and cost-saving measures. The five requirements of CPC classic physician practices will stay the same: care access, management, and coordination; patient/caregiver engagement; and planned care.
Reductions in areas such as utilization of care, hospital admissions, and specialist and emergency department visits are leading to industry-wide shifts in the traditional fee-for-service model to a more team-based approach. Better chronic disease management and improved transitions of care put the patient and their care team at the center of health care decision-making.
As the nonprofit health and health care improvement organization chosen by CMS to support participating CPC classic practices, The Health Collaborative has been there every step of the way.
Now with the kickoff of CPC+, the team at The Health Collaborative looks forward to reprising its role and expanding its support services to the entire state of Ohio and parts of Northern Kentucky. It is by far the largest territory in the CPC+ program, encompassing 562 total practices (brick-and-mortar sites, not practice groups with multiple locations) across all 88 counties in Ohio and four counties in Northern Kentucky.
According to the CMS website, CPC+ supports 2,983 total primary care practices nationwide, comprising 13,090 clinicians and serving more than 1.76 million Medicare beneficiaries. The Health Collaborative is proud to play a role in advancing improvements in population health outcomes, at the front lines of innovation in patient care.
About the Health Collaborative
The Health Collaborative is a nonprofit organization that strives to positively impact health status, experience, outcomes, and affordability by fostering a connected system of health care and community health through innovation, integration, and informatics in the greater Cincinnati region. For more information about the Health Collaborative, visit its website.