CMS Announces Model to Improve Access to High-Quality Primary Care for Underserved Medicare Populations
CMS Announces Model to Improve Access to High-Quality Primary Care for Underserved Medicare Populations
The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced a new voluntary model that empowers primary care providers in eligible Accountable Care Organizations (ACOs) to treat people with Medicare using innovative, team-based, person-centered proactive care. A key part of the Biden-Harris Administration’s efforts to further promote competition in health care, the ACO Primary Care Flex Model (ACO PC Flex Model) will provide a one-time advanced shared savings payment and monthly prospective primary care payments to ACOs. The model aims to drive better outcomes for underserved populations by increasing access to higher-quality primary care, which can include unique services such as proactive care management, patient navigation, and behavioral health integration.
The CMS Innovation Center will test this new model within the Medicare Shared Savings Program. The model will focus on and invest in low revenue ACOs, which tend to be smaller and mainly made up of physicians. Low revenue ACOs have historically performed better in the Shared Savings Program, demonstrating more savings and stronger potential to improve the quality and efficiency of care delivery. The ACO PC Flex Model’s payment structure also promotes competition by providing a pathway for low revenue ACOs, which often have fewer resources, to continue serving people with Medicare while providing an alternative for physicians to stay independent.
CMS anticipates releasing a model Request for Applications in the second quarter of 2024.
More information about the model can be found on the model webpage and in the ACO PC Flex Model press release. For updates on the model, please register for the model listserv.
A public overview webinar will be hosted to offer more information about the model:
- 2-3 p.m. EST on Thursday, April 4
- Visit the webinar registration page to sign up
