SUSANNAH LUTHI April 22, 2019
HHS on Monday launched an ambitious,
double-pronged strategy to shift primary care from fee-for-service payments to
a global fee model where clinicians and hospitals can assume varying amounts of
risk.
HHS Secretary Alex Azar told a crowd of
stakeholders at the American Medical Association in Washington the new programs
are expected to shift at least a quarter of people in traditional Medicare out
of fee-for-service.
The first model offers two payment options where
small primary care practices will get a set, flat fee per patient. Bonuses or
penalties will depend on their ability to keep their patients "healthy and
at home," CMS' Innovation Center Director Adam Boehler said.
For larger practices and health systems, there
are additional voluntary models. Under the first "professional
option," providers would assume 50% of the risk, including savings and
losses. Under the "global option," providers would take on full risk.
There is also a "geographic option,"
where health systems or plans could assume the risk for the total cost of
primary care in their local communities.
Nearly all the models will launch in January
2020, with the geographic option projected to begin mid-year 2020.
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