Value Based Care Model for PCPs with an Eye Toward Growth

Primary care practices take note. If you’re looking for new opportunities to increase your patient census and revenue, the Primary Care First (PCF) model, first launched by the Centers for Medicare & Medicaid Services (CMS) in January 2021, is now accepting applications for Cohort 2. There isn’t much time to act. The application deadline is April 30.

The program, which will begin for Cohort 2 in January 2022, is now open to practices in 26 regions nationwide that specialize in internal medicine, general medicine, geriatric medicine, family medicine, and/or hospice and palliative medicine — not just CPC+ participants.

PCF Benefits Patients and the Providers Who Serve Them

CMS designed its newest value based care program to make it easier for patients to find primary care providers and for providers to maximize their revenue.

Unlike previous value based plans, PCF gives primary care practices the freedom to develop their own approach to care delivery, based on the health needs of the patients they serve. With a simpler payment structure, fewer requirements, and less paperwork, providers have more time to spend with patients. That means more time to improve patient experience and outcomes —results that reap rewards for everyone.

Quantifying Potential Gains

PCF participation can result in performance-based adjustments of up to 50% of revenue based on a single outcome measure. The more high-risk, high-utilization patients a practice serves, the higher the potential rewards.  As an example of what’s possible, one of Acclivity’s primary care group clients has earned over $500,000 in incremental income since the program began on January 1, 2021.

While there is not enough time before the application deadline to determine how much your own practice will benefit, there will be time after your application is accepted to determine if the program is the right fit for you.

Getting The Right Support

The application is not hard to fill out. In fact, it’s pretty straightforward. But applying for PCF does not guarantee acceptance. Acclivity helped dozens of practices apply for PCF in 2020. We know what CMS is looking for and the responses that will get your application the attention it deserves. So, we are extending that same help to practices who want to apply this year.

Why? Because our mission is to improve the quality of care management for patients with advanced illness. And we believe that this program is a critical next step in that process.

If you are ready to apply or have questions about PCF, please contact us to learn how we can both help you with your application.

Once you are accepted, Acclivity can provide easy access to actionable, timely data to help you determine when and how often you need to see your patients to prevent chronic conditions and reduce over-utilization of higher cost care settings.   

Additional Resources

We are hosting sessions with MGMA and AAHCM. Don’t miss our featured webinars that will provide you with the knowledge to: 

• Examine how PCF improves patient access to advanced primary care  
• Breakdown the two major components of PCF payment options for maximizing additional reimbursements and bonus payments 
• Outline what new resources your practice may need to make the program most profitable 

MGMA, 3/25/21 at 1 pm ET  How to Increase Revenue with CMS PCF

AAHCM, 4/1/21 at 4 pm ET Increase Revenue and Enhance Care with CMS PCF

For more information or application assistance, please contact us at PCF@8kw.3ce.myftpupload.com.