KC Selected for Comprehensive Primary Care Plus Initiative

The Centers for Medicare and Medicaid Services (CMS) has selected the Kansas City region as one of 14 markets for its most recent innovation effort, Comprehensive Primary Care Plus (CPC+). Kansas City’s selection was made based on a proposal submitted by Blue Cross and Blue Shield of Kansas City (Blue KC).

The CPC+ initiative supports enhanced, comprehensive primary care by offering an innovative payment structure that rewards high-quality, cost-efficient care delivery and begins to move primary care payments away from sole reliance on fee-for-service reimbursements. The CPC+ model is built on the foundation of the Comprehensive Primary Care (CPC) initiative, which began in October 2012 and runs through December 31, 2016.

One of the key learnings gained from the CPC initiative is that participation from multiple payers helps providers make more rapid and meaningful changes toward delivering proactive comprehensive primary care. Kansas City was selected by CMS, even though Blue KC was the only payer from the Kansas City region to submit a CPC+ application. In its acceptance letter to Blue KC, CMS stated that it is “confident in your proposal’s alignment with CPC+” and that Blue KC’s market presence “is sufficiently robust to proceed without other payers.”

“At Blue KC, we believe that stronger primary care is essential to supporting healthy populations and reducing the cost of healthcare in the U.S. This is one of the major motivations for launching the Blue KC Medical Home program in 2010 which works with primary care practices across the region to bring more patient-focused, comprehensive and coordinated care to our members. We have seen very favorable outcomes from this effort which is why we’re so motivated to bring the CPC+ opportunity to the Kansas City Region,” said Dr. Gregg Laiben, Vice President of Health Innovations at Blue KC.

2 Comments

  1. Shelly Toft on March 28, 2017 at 7:05 am

    This article states what the CPC+ model desires to accomplish, but gives no information about how to reach your goal. What does “participation from multiple payers helps make providers make more rapid and meaningful changes…” This does not tell me anything.

    • BlueKC on March 30, 2017 at 12:32 pm

      CMS designed the CPC+ model around learnings gained from the original pilot, the Comprehensive Primary Care Initiative, launched in 2012. In the six regions that participated in this pilot program, CMS found that regions demonstrating the most significant improvements in higher quality and lower cost were those with multiple payers working together. Dr. Laura Sessums, MD from CMS underscores this point in a 2015 JAMA Viewpoint article stating that “Multipayer support has been an essential element for CPC practices to change care delivery for their entire patient panel.”

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