Primary Care First Model: Seriously Ill Population Component Update

Primary Care First Model: Seriously Ill Population Component Update Today, the Centers for Medicare & Medicaid Services (CMS) is announcing that, after careful consideration, it will not move forward with the Seriously Ill Population (SIP) Component of the Primary Care First (PCF) Model. The SIP component of Primary Care First was designed to have advanced primary care practices, including providers whose clinicians are enrolled in Medicare and who typically provide hospice or palliative care services, coordinate care for high need, seriously ill beneficiaries. SIP proposed a novel method for identifying and attributing eligible beneficiaries to participants. A beneficiary outreach process that effectively engages and recruits beneficiaries is central to the SIP component and is necessary to ensure that there are enough beneficiaries to allow for a robust evaluation of the model. After careful review, CMS has determined that the proposed SIP outreach method, which was designed to comply with statutory beneficiary privacy protections, is unlikely to result in sufficient beneficiary uptake to allow for model evaluation. The Innovation Center is committed to testing interventions focused on improving care for seriously ill beneficiaries. As part of the Innovation Center’s strategy refresh, we will be exploring additional ways to serve these beneficiaries, whether through existing models or new model opportunities. We look forward to providing more information when available. Follow us on Twitter | Visit the CMS Innovation Center website

Centers for Medicare & Medicaid Services (CMS) has sent this update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.