Medicare’s Vision for Advanced Primary Care

New Directions for Care Delivery and Payment

Consistent with the goals of the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act of 2015, the Centers for Medicare & Medicaid Services (CMS) is increasingly paying for health care through alternative payment models that reward value and quality.1 These models include accountable care organizations, bundled payments, and advanced primary care medical homes. In this Viewpoint, we focus on advanced primary care medical homes.

Primary care is central to a high-functioning health care system.2 Advanced primary care medical homes are practices supported by payment, health information technology, and data that transform their delivery of care while accountable for the cost and quality of care their patients receive. Regardless of size or ownership structure, these practices can likely improve the quality and experience of care for their entire population of patients. These changes also could lead to reductions in unnecessary health care utilization and cost of care.3

To that end, CMS is launching its largest investment in advanced primary care to date: the Comprehensive Primary Care Plus (CPC+) model. The design of CPC+ was informed by both stakeholder input and CMS’ experience with the original CPC initiative, an Innovation Center model that began in 2012 and is scheduled to end later this year. CPC+ represents the next step in advanced primary care for both care delivery and payment design.

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