The pMD Blog

Welcome to the
pMD Blog...

where we cover interesting and relevant news, insights, events, and more related to the health care industry and pMD. Most importantly, this blog is a fun, engaging way to learn about developments in an ever-changing field that is heavily influenced by technology.

The 411 on CPC+

In a traditional fee-for-service payment model, providers are retroactively paid for each service rendered on a patient. The incentive for quality care is shadowed by the pressure to deliver additional services in order to receive higher reimbursements. The new Comprehensive Primary Care Plus (CPC+) value-based model is changing the way primary care practices receive payments and shifts the focus to strategies that promote coordinated, patient-centered care.

What is Comprehensive Primary Care Plus?

As of January 1, 2017, the Centers for Medicare & Medicaid Services, or CMS, has kicked off the CPC+ program. CPC+ is a model that aims to strengthen primary care through regional multi-payer payment reform that ties the provider to specific cost targets.

These 5,000 provider participants across 14 selected regions now have the ability to earn bonus fees in addition to their traditional fee-for-service rates. One of the unique aspects of CPC+ is that it is not limited to just Medicare or Medicaid beneficiaries.

The CPC+ application deadline was September 15th, 2016 and approved participants have already been selected in the following regions:



Care Delivery Requirements

CPC+’s care delivery requirements are broken out over several functional categories:

1) Access and Continuity - Expanded access to a patient’s primary care team. Expanded hours or alternatives to traditional office visits are a couple of ways that this requirement can be met. The goal is to reduce costly urgent and emergency care.

2) Care Management - The identification of high-risk, high-need patients and the provision of longitudinal care and episodic care management in order to improve outcomes for the identified patients. The use of care plans focused on goals and strategies that are aligned with the patient's values and decisions is a key requirement.

3) Comprehensiveness and Coordination - Comprehensiveness builds on the patient / provider relationship that is the center of primary care. It is the ability of a practice to meet the majority of a patient’s health and social needs in pursuit of each patient’s health goals. Achieving this goal includes the use of analytics to identify and prioritize needs of a patient population, offering services within a practice that may have previously required a referral, and facilitating care through co-management or closed-loop referrals with specialists within the community for services that are best provided outside of the primary care practice. These are key components to delivering on this requirement.

4) Patient and Caregiver Engagement - CPC+ requires patient and caregivers to be engaged in the management of their own care as well as in its design and improvement of delivery. Participating practices are expected to organize a patient and family advisory council (PFAC) to help understand the perspective of patients and caregivers on the practice and its delivery of care. Practices will use the PFAC recommendations to help them improve care delivery and ensure that a patient-centric model is maintained.

5) Planned Care and Population Health - The organization of care to meet the needs of the entire patient population a practice serves. Practices are expected to pro-actively offer timely and appropriate preventative care as well as consistent evidence-based management of chronic conditions. Population health will be improved through the use of evidence-based protocols in team-based care as well as identification of care gaps at the population level. Importantly, practices are required to measure and act on quality of care provided at the practice level.

Strengthening primary care is critical to ensuring an effective health care climate. By providing doctors and clinicians with the right tools, CPC+ participants can more readily meet their care delivery requirements. pMD’s care coordination product enables caregivers to communicate with each other about their shared patients, connects health care teams together onto one patient-centric care management platform and allows providers to send secure, HIPAA-compliant messages in real-time about their patients. By allowing providers to focus on spending more time with patients, we can continue to build a health care system that results in healthier patients and more responsible spending of health care dollars.
5G ACA Account Management accurate coding ACI adoption Advancing Care Information Advice AHCA AHRQ AI Alternative Payment Model Amazon S3 Android API Apple appointment reminders Artificial Intelligence arts Audit Award Bay Area BCRA Benefits Best Place to Work Best Practices Big Data Billing Billing & Collections Billing Service Billing Services bootcamp BPCI BPTW Bundled Payment Model Bundled Payments Business relationships Care Communities care coordination Care Navigation Care Team Career Fair CDC Charge Capture Charge Capture App Charge Capture Software Charge Capture Solution Charge Capture Statistics Charge codes Charge Lag Charge Reconciliation CHIP CIO Claims Clinical Communication clinical data Clinical Data Registry Clinically integrated network Cloud CMS cms regulations Coding Collaboration Communication Company Culture Conferences Connected Health Record contact practice Coronavirus COVID COVID-19 COVID19 Cross-functional culture custom reports Customer Interaction customer relations customer service customer success customer support Customers Cyber Security cybersecurity Developer DHHS Diagnosis codes Dialysis discharge instructions Doctor EHR elderly Electronic Charge Capture Eligibility EMR Encryption End-to-End Platform epidemic Expansion FDA FHIR Flu fundamentals gamification Gen Z GI GI Outlook Goals group messaging Health Care Health Care Technology Health Care Web Health Care. Health Care IT health data Health Information Exchange Health Record Healthcare Healthcare Data healthcare interface healthcare interface integration healthcare software HIE HIPAA HIPAA Compliance hipaa compliant communication hipaa compliant communication platform HIPAA-Compliant Hiring HL7 Holidays Home dialysis Home Health Hospital Census Hospital Communication humanity IA ICD-10 ICD-11 Immunizations Implementation Improvement Activities in-app calling inclusive software incorrect billing increase revenue injury rehabilitation innacurate coding Instant capture Integration interface interoperability iOS iOS 8 iOS7 iPad iPhone iPhone 6 IT Lead Generation length of stay LGBTQIA Long Term Care LTC Machine learning MACRA Medaxiom Medical Billers Medical Billing Medical Billing & Collections medical billing denials and solutions Medical claims Medical Coding medical coding accuracy medical coding quality Medical Errors medical practice revenue Medical Record Medical Software Medicare Mental Health Mentorship Messaging Messaging with Patients MGMA MIPS MIPS Registry mobile Mobile App Mobile Charge Capture Mobile EHR Mobile Health Mobile Messaging Mobile Payments Mobile security Mobile Software Mobile Technology Mobile telehealth Modern Healthcare Native App natural language processing Network new feature new features news NIH nlp OCM onboarding Oncology Care Model operations opioid crisis Pandemic Parenting Partnership partnerships Patient Patient access Patient Adherence Patient App Patient Care Patient Chat Patient chat routers Patient Communication patient data Patient Engagement patient experience patient experience cycle Patient Generated Health Data Patient Handoff Software Patient Information Patient Messaging patient outcomes Patient payments patient portal Patient Record Patient Safety Patient satisfaction Patient Simulators patient support Patient Visits Patient-Centric PCP Performance bonus PHI Phishing Scams Physician Physician burnout pmd pMD Pro pMD Team population health Population Health Management Post-COVID PQRS Practice Management Pregnancy Press Release Product Development Productivity products Promoting Interoperability Protected Health Information QCDR QPP Quality Data quality reporting Quality Scoring Ransomware RCM Recruiting Recruitment Reimbursement remote jobs Remote Work Reporting reports Residents Responsibility revenue cycle management ROI Rural communities Ryuk Sales Secure Communication Secure Data Secure Messaging Secure Messaging Video Secure Text Messaging Secure Video Secure Video Chat Security Audit self care seniors sexual orientation and gender identity SF Biz Times SMB SNF SNOMED-CT SOC 2 software vendor SOGI Spear Phishing Specialty Care success support TCM TDM Team Team culture Teamwork technology telehealth telehealth reporting Telemedicine telemedicine in long term care Telemedicine skilled nursing facilities Teletherapy Text Messaging texting Thanksgiving Therapeutic Drug Monitoring time-based billing training transgender Travel Upgrades UX Design VA vaccination records vaccinations Vaccine Value-based care Video Calling Video chat video communication video conferencing Virtual Care Virtual Visit voice calling voice memos WannaCry Wearable Device wearing many hats Web App wellness wfh Wireless Work From Home Work Life Balance Workflow optimization Workplace Culture