Advanced Primary Care: A Foundational Alternative Payment Model (APC- APM) for Delivering Patient-Centered, Longitudinal, and Coordinated Care–American Academy of Family Physicians (AAFP)
In its proposal to the Physician-Focused Payment Model Technical Advisory Committee of the CMS, the AAFP noted these key findings:
In a simulation model, a permanent 10% increase in Medicare fees for primary care ambulatory visits resulted in a six-fold annual return on investment in the form of lower Medicare costs for other services, primarily inpatient and post-acute care.
The Rhode Island insurance commissioner reported that a 23% increase in primary care spending between 2007 and 2011 was associated with an 18% reduction in total spending—a 15-fold return on investment.
Additionally, a 2016 Portland State University study found that every $1 increase in primary care expenditures in Oregon’s Patient-Centered Primary Care Home (PCPCH) program resulted in a $13 savings in specialty care, ED, inpatient care, and other healthcare services. Practice teams promoting six core attributes of primary care achieved $240 million in savings in the first three years of the program—$41 in savings per patient, per quarter.
Based on these and other studies, the Centers for Medicare & Medicaid Services recently announced the CMS Primary Cares Initiative, a new set of payment models that will transform primary care to deliver better value for patients throughout the healthcare system.
The Primary Care First model reduces administrative burdens, promotes a return to patient-centered and relationship-focused care, and reduces the overall cost of healthcare. Primary Care First options will be offered in 26 regions of the US starting in January 2020.
Primary Care Insights will help you address current challenges and prepare you for big changes ahead in the way we pay for and deliver healthcare. Let us help you implement team based-care with a train-the-trainer approach that’s scalable across your healthcare system. Be on the cutting edge of change.