CMS reviewing part of Primary Care First payment model

CMS Primary Care First model options will be offered in 26 regions beginning April 1, the agency said March 9.

Primary Care First, a set of voluntary five-year payment options, was designed to decrease the number of avoidable hospital visits and total cost of care through performance-based adjustments. The 864 practices CMS selected as participants generally include primary care clinicians who serve seriously ill populations in high need of care.

CMS will use clinical quality and patient experience measures to evaluate the quality of care each Primary Care First practice delivers, and a practice must meet CMS standards to receive a positive performance-based adjustment to its primary care revenue. Such measures include a patient care experience survey, controlling high blood pressure, colorectal cancer screening and advance care planning.

The model's seriously ill population component is under review, and will not begin on the April 1 start date. CMS will guide patients from the seriously ill population who lack a primary care practitioner or care coordination to practices that opted to participate in the seriously ill population component. 

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