Case Management

News: Primary care initiative aims to provide quality care at lower cost

Case Management Weekly, July 11, 2012

CMS will join forces with 45 commercial, federal, and state insurers in its Comprehensive Primary Care Initiative that aims to give more Americans access to quality healthcare at lower cost, the agency announced in a recent press release

Participants include insurers in:
  • Arkansas
  • Colorado
  • New Jersey
  • Oregon
  • New York’s Capital District-Hudson Valley Region
  • Ohio and Kentucky’s Cincinnati-Dayton Region
  • Greater Tulsa, Okla. 

CMS will select approximately 75 primary care practices to participate in the initiative in each market. Primary care practices interested in participating should complete the CMS Center for Medicare & Medicaid Innovation application pre-screening tool. CMS will accept applications until July 20. 

CMS will pay primary care practices a care management fee, initially set at an average of $20 per beneficiary per month, to support enhanced, coordinated services, according to the press release. Participating primary care practices must agree to provide enhanced services for their patients, such as:

  • Offering longer and more flexible hours
  •  Implementing electronic health records
  • Offering preventive care
  • Coordinating care with other providers
  • Engaging patients and caregivers in managing their own care
  • Providing individualized care for patients with multiple chronic diseases and higher needs


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