Primary Care First

Unlock the Value of Primary Care First

The Centers for Medicare & Medicaid recently unveiled their Primary Care First (PCF) model to improve the quality of care for Medicare patients while reducing costs. The Seriously Ill Population model under PCF is designed for high-need, high risk patients who are receiving fragmented or inadequate care. This new model will be offered in 26 states and regions beginning Jan. 1, 2020.

How will Primary Care First-SIP Work for You

Under the new Primary Care First–Seriously Ill Population (PCF-SIP) Option, participating hospice and palliative care organizations can reap financial rewards by coordinating the care of patients with advanced illnesses and keeping them out of the hospital. Some benefits to you include:

  • Reimbursement for services you can’t bill for today
  • Bonus opportunities when patients are well-managed
  • Earlier access to hospice-ready or soon-to-be hospice appropriate patients
  • Increased referrals through stronger relationships with community providers
  • Experience working with Medicare Advantage payers, giving you an advantage over other hospices

Educational Sessions Designed For You

Attend our Upcoming Webinar:

October 24 at 2:00 p.m. ET.

Seriously Ill Population Program from CMS Statewide in January – How to Win in the Age of Reimbursement Reform

To register click here.

As an NHPCO Edge Partner, we recently presented a two-part webinar series: Current and Emerging CMS Payment Models: Intersection between Hospice, Palliative and Primary Care.

Part 1 provides an understanding behind medicare’s urgency, and important considerations including economic model announcements, risk intermediaries, new expectations and requirements, new competition, and the economics of evolution. To listen to Part 1 click here

Part 2 dives deeper and covers  hospices’ readiness to provide SIP programming as well as the specific areas for providers to address around staffing, care provision, documentation, on-call, data analysis, budgeting, internal culture, marketing, networking, and contracting. To listen to Part 2 click here.

NHPCO Podcast:  Seriously Ill Population

Hospice providers are in a unique position to meet patient and family needs outside of the hospice model.  Hear how the CMS Serious Illness Population Model is such an opportunity for providers to reach people earlier in the course of illness and develop a potentially new revenue source for many services programs you are already skilled at providing. Listen to the podcast.

Acclivity Health is pleased to partner with NHPCO through its Edge program. Learn more.

At Acclivity, we are dedicated to helping you navigate through these options. The resources on this page have been developed to help you understand, assess benefits, and participate in the program.

Resource library

blog posts


Access CMS

we do

Want to learn more about primary care first and how acclivity can help you realize its full potential?