Six of the eight states that are currently participating in the Centers for Medicare & Medicaid Services Multi-Payer Advanced Primary Care Practice demonstration model Maine, Michigan, New York, North Carolina, Rhode Island and Vermont have been offered an extension through 2016. CMS has offered to extend the demonstration in states for which some of the MAPCP demonstration payment goes to community-based organizations that could not bill independently under the Chronic Care Management codes proposed to take effect in January 2015.
The eight states, including Pennsylvania and Minnesota, were selected to participate in the ongoing model that began in 2010.
The demonstration program pays a monthly care management fee for beneficiaries receiving primary care from advanced primary care practices. The care management fee is intended to cover care coordination, improved access, patient education and other services to support chronically ill patients.
Each project, conducted and coordinated by the participating state, includes Medicaid and substantial participation by private health insurers, shows support by the primary care providers and is coordinated with state health promotion and disease prevention efforts.
Additionally, each participating state has mechanisms to offer APC practices community support and linkages to State health promotion and disease prevention initiatives.
Medicare participation started July 11, 2011, in Vermont, New York, and Rhode Island. North Carolina and Michigan began participation Oct. 1, 2011, and Maine, Minnesota, and Pennsylvania became operational Jan. 1, 2012. At the start of 2015, each states program will have been operational for at least three years, with an expected participation of about 1,200 medical homes serving more than 900,000 Medicare beneficiaries.
CMS participates in multipayer reform initiatives that are being conducted by states to make advanced primary care practices more broadly available. The demonstration evaluates whether advanced primary care practice will reduce unjustified utilization and expenditures; improve the safety, effectiveness, timeliness and efficiency of healthcare; increase patient decision-making; and increase the availability and delivery of care in underserved areas.
To view an interactive map of this model, visit the Where Innovation is Happening page at www.CMS.gov.