Oregon was selected by the Centers for Medicare and Medicaid Services (CMS) as one of 14 regions across the country to implement
Comprehensive Primary Care Plus (CPC+).
CMS refers to CPC+ as the
"largest-ever multi-payer initiative to improve primary care in America." In January 2018, CMS opened up Round 2 of CPC+ for new CPC+ regions and additional payers in current CPC+ regions. Round 2 ran for four years, completing at the same time as CPC+ Round 1, and concluded in December 2021. Round 2 resulted in four more CPC+ regions (for a total of 18) and three more participating Oregon payers (marked with an asterisk below), for a total of 19 participating Oregon payers. The majority of participating practices outperformed the 50% prospective payment and earned additional performance-based payment.
CPC+ was a regionally based, multi-payer advanced medical home model offering an innovative payment structure to improve health care quality and delivery. It was a five-year federal program beginning in January 2017 that brought significant Medicare dollars to Oregon.
Over 150 practices in Oregon were selected to participate in CPC+. The practices were diverse and varied by size, organizational structure, geographic location and practice type. All participating practices were required to be recognized as a
Patient-Centered Primary Care Home (PCPCH) by the Oregon Health Authority (OHA).
Sixty-five practices participated in the first
Comprehensive Primary Care initiative, bringing $12 million of additional funding paid directly to primary care practices. Oregon's more robust participation in CPC+ will bolster our efforts to move from fee-for-service to a system that pays for outcomes.
The Oregon CPC+ payers formed the
Oregon CPC+ Payers Group and met monthly to:
- Collaborate to support sustainable primary care transformation that results in healthier patients and lower costs
- Identify and share payer and clinic best practices to achieve program care delivery and payment model goals
- Align to reduce fragmentation, seek simplification, and leverage existing resources
- Seek to understand and demonstrate the value of the model to change expectations of how primary care is funded
Oregon payers participating in CPC+
Oregon Health Authority fee-for service Medicaid
Commercial payers
- CareOregon
- Moda Health Plan, Inc.
- PacificSource
- Providence Health Plan and Providence Health Assurance
- UnitedHealthcare*
Coordinated care organizations (CCOs)
- Advanced Health
- AllCare CCO, Inc.
- Columbia Pacific CCO
- Eastern Oregon CCO
- Health Share of Oregon (not a CPC+ payer, but represented by CareOregon and Providence, participating Health Share of Oregon payer partners)
- InterCommunity Health Network*
- Jackson Care Connect
- PacificSource Central Oregon
- PacificSource Columbia Gorge
- PrimaryHealth
- Trillium CCO*
- Willamette Valley Community Health Organization
- Yamhill Community Care Organization
*Joined CPC+ for Round 2, which began January 1, 2018, and ran for four years, completing at the same time as CPC+ Round 1.
Background
Overview of CPC+ (Centers for Medicare and Medicaid Services)
Contact