Medicare recipients will have greater access to health services under a provision of the Patient Protection and Affordable Care Act of 2010 that will pump $42 million in funds to 500 community health centers in 44 states.
The new funding was announced Oct. 24 by the U.S. Department of Health and Human Services. The initiative, made possible by the Affordable Care Act, is aimed at improving the quality of care for Medicare patients throughout the country.
Over three years, HHS is allocating approximately $42 million to health centers across the country in an effort to help clinicians in those centers to improve care coordination for some 195,000 Medicare recipients across the country. CMS selected 500 practices out of 800 that applied to participate in the program.
Under the program, dubbed the Advanced Primary Care Practice demonstration, the federal Medicare program will pay community health centers based on the quality of care they deliver. This new payment demonstration will encourage community health centers to become patient-centered medical homes by rewarding clinics for such things as helping patients manage chronic conditions like diabetes or high blood pressure.
“Becoming an [Advanced Primary Care Practice] requires that a medical practice change the way it delivers medical care to its patients,” CMS said in a document about the program. “This transformation requires considerable thought and planning by a medical practice and may require various levels of investments in both time and money.”
Health centers will use the funds from the program demonstration to do things like expand their hours, make same day appointments and accommodate patients with urgent care needs.
“The goal of this demonstration is to help patients get the care they need in a primary care setting rather than in an emergency department,” Centers for Medicare and Medicaid administrator Dr. Don Berwick said in a statement. “When patients are able to use a health center as their primary source of care, it helps primary care doctors, nurses and specialists coordinate their care.
The demonstration will be conducted from Nov. 1 through Oct. 31, 2014. At the outset of the program, participating community health centers will receive a monthly care management fee of $6 for each eligible Medicare beneficiary attributed to their practice to help defray the cost of transformation into a person-centered, coordinated, seamless primary care practice. Beginning Nov. 15, participating health centers will be also be paid a quarterly prospective care management fee of $18 for each Medicare beneficiary identified by CMS.
The CMS Center for Medicare and Medicaid Innovation – also known as the Innovation Center – and the Health Resources Services Administration will also provide technical assistance in the form of educational and training sessions as well as webinars on medical home recognition standards to help participating community health centers throughout the demonstration. Technical assistance will be provided at no extra cost to participating centers.
Throughout the three-year demonstration, the Innovation Center will conduct an independent evaluation that will look at the process and challenges involved in transforming community health centers into advanced primary care practices. The evaluation will assess the project’s impact on hospital admission rates, emergency department visits rates, access, quality and cost of care provided to Medicare beneficiaries. The evaluation will also evaluate whether the demonstration was successful in lowering healthcare costs.
“The lessons learned from this demonstration project will help all community health centers improve on their longstanding commitment to providing high quality, patient-centered primary care,” HRSA administrator Dr. Mary K. Wakefield said in a statement.
More information on the Advanced Primary Care Practice demonstration project, including a fact sheet, and a list of participating health centers can be found at
http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/fqhc/.
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