The Obama administration on Monday rolled out an expansive new effort under Obamacare aimed at paying family doctors based on the quality of care they deliver, instead of a regular fee for service.
The Centers for Medicare and Medicaid Services announced the Comprehensive Primary Care Plus voluntary model, which will encompass more than 25,000 family doctors and affect about 25 million patients. The initiative aims to push doctors toward giving patients 24-hour access to care, delivering more preventive care.
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“It takes patients off the assembly line and puts them at the center of their care,” said Patrick Conway, CMS deputy administrator, during a Monday call with reporters. “Instead of paperwork and checking boxes, [doctors] will focus on what really matters.”
Under the model, participating doctors would get upfront financial incentives from Medicare if they focus on the quality of care they deliver. These incentives would be in addition to the traditional fee-for-service payments that doctors receive from Medicare.
The incentives can be up to $28 per Medicare beneficiary per month depending on how doctors participate.
Doctors using the model will have to meet certain benchmarks in order to keep the money, including engaging with families and giving patients 24-hour access to care and health information.
CMS couldn’t say how much money overall will be doled out under the five-year program. Conway told reporters that the model would allow doctors to participate in two tracks, one of which would focus on more complex care.
CMS projects that the first track will be budget neutral, and the second track will result in savings of $2 million over the duration of the program.
The funding comes from the CMS Innovation Center, which was created under Obamacare to conduct payment and quality experiments.
Conway said the program will try to partner with insurance plans and state Medicaid programs in order to provide consistent goals for doctors on how to provide better quality of care. That way the doctors won’t get mixed signals from different payers, he said.
Obamacare made a major push to shift Medicare from the traditional fee-for-service model that pays doctors for a specific test or service. The administration wants to tie Medicare payments for doctors and hospitals to certain benchmarks based on quality.
For example, the administration has tried to reimburse certain hospitals based on the number of patient readmissions, which can determine the quality of care.
