Medicare Program; Comprehensive Primary Care Initiative, 61103 [2011-25356]

Agencies

• Centers for Medicare & Medicaid Services
• DEPARTMENT OF HEALTH AND HUMAN SERVICES

[Federal Register Volume 76, Number 191 (Monday, October 3, 2011)]
[Notices]
[Page 61103]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-25356]



[[Page 61103]]

=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-5508-N]


Medicare Program; Comprehensive Primary Care Initiative

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: This notice announces a solicitation for health care payer 
organizations to participate in the Comprehensive Primary Care 
initiative (CPC), a multipayer model designed to improve primary care.

DATES: Letter of Intent Submission Deadlines: Interested organizations 
must submit a nonbinding letter of intent (LOI), which includes an 
Excel document identifying preliminary markets of interest by November 
15, 2011 using the LOI template provided on the Innovation Center Web 
site at https://www.innovation.cms.gov/.
    Application Submission Deadline: Applications must be received 
through an online portal, on or before 5 p.m., Eastern Standard Time 
(E.S.T) on January 17, 2012. We reserve the right to request additional 
information from applicants in order to assess their applications.

ADDRESSES: Letters of Intent should be submitted electronically in PDF 
format via encrypted e-mail to the following e-mail address by the 
applicable date specified in the DATES section of this notice: 
CPCi@cms.hhs.gov. Letters of Intent will only be accepted via e-mail. 
Applications will only be accepted via the online application portal.

FOR FURTHER INFORMATION CONTACT: CPCi@cms.hhs.gov for questions 
regarding the aspects of the Comprehensive Primary Care initiative or 
the application process.

SUPPLEMENTARY INFORMATION: 

I. Background

    The Centers for Medicare & Medicaid Services (CMS) are committed to 
the three-part aim of better health, better health care, and lower per-
capita costs for Medicare, Medicaid and Children's Health Insurance 
Program (CHIP) beneficiaries. One potential mechanism for achieving 
this goal is to support practice redesign in primary care through 
payment reform.
    The Center for Medicare & Medicaid Innovation (Innovation Center) 
is seeking to strengthen free-standing primary care capacity by testing 
a model of comprehensive, accountable primary care supported by 
multiple payers. We are seeking to collaborate with other payers in 
select markets and with approximately 75 primary care practices in each 
market over the course of this 4-year initiative. This solicitation is 
directed to public and private health care payers who will respond 
individually to the Innovation Center. Once payers and markets have 
been selected, primary care practices will be recruited and selected in 
those markets.

II. Provisions of the Notice

    Consistent with its authority under section 1115A of the Social 
Security Act (the Act) as added by section 3021 of the Affordable Care 
Act, to test innovative payment and service delivery models that reduce 
spending under Medicare, Medicaid or CHIP, while preserving or 
enhancing the quality of care, the Innovation Center aims to achieve 
the following goals through the implementation of the Comprehensive 
Primary Care (CPC) initiative:
     To collaborate with other payers on aligned strategies to 
support the delivery of comprehensive primary care services provided by 
practices participating in the initiative (as described in Section D of 
the solicitation).
     To test whether a set of comprehensive primary care 
functions, coupled with payment reform, use of data to guide 
improvement, and meaningful use of health information technology can 
achieve the three-part aim of better care, improved health and reduced 
costs that could ultimately be adopted by Medicare and Medicaid 
programs.
    We will pay a per-beneficiary-per-month care management payment to 
each participating primary care practices for comprehensive primary 
care services that the practice provides to its Medicare fee-for-
service beneficiaries We will offer an opportunity for participating 
practices to share in savings in years 2 through 4 of the program if 
the market in which the practice participates experiences reductions in 
its reductions in its total health system costs (a described in Section 
F of the solicitation). Each payer applying for this initiative will 
propose a strategy that is aligned with the Innovation Center's 
approach to supporting comprehensive primary care. Learning systems 
will support participating practices throughout the initiative. Payer 
selection criteria are described in section II of the Solicitation.
    To the extent that States apply, the Innovation Center will also 
pay a per-beneficiary-per-month care management payment to primary care 
on behalf of Medicaid fee-forservice beneficiaries; shared savings will 
not be a part of the payment methodology for Medicaid fee-for-service.

III. Collection of Information Requirements

    Section 1115A(d)(3)of the Act specifies that the requirements of 
the Paperwork Reduction Act of 1995 do not apply with respect to the 
testing and evaluation of payment and service delivery models or the 
expansion of these models under section 1115A of the Act.

    Authority: Section 1115A of the Social Security Act.

    Dated: September 27, 2011.
Donald M. Berwick,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2011-25356 Filed 9-28-11; 11:15 am]
BILLING CODE 4120-01-P