The Governor’s Office of Health Transformation will launch a statewide initiative next year designed to improve the quality of primary care with enhanced payments for physicians, while at the same time reducing the cost of care by promoting a more efficient delivery model.
The state has partnered with downtown Dayton-based CareSource and four other Medicaid managed care organizations, along with the four largest commercial health plans and a limited number of primary care practices across the state to implement the new Comprehensive Primary Care (CPC) program.
“The CPC initiative will further increase attention to the health care needs of our members, promote better outcomes, help increase member satisfaction, and mitigate cost increases for thousands of Ohioans participating in Ohio’s Medicaid program,” said Steve Ringel, president of the Ohio market for CareSource.
The program will allow approved primary care practices to earn bonus payments for providing coordinated care to patients through a team-based delivery model known as patient-centered medical homes.
When the program is fully implemented in 2018, participating primary care doctors will receive monthly bonus payments of about $4 per patient, on average, according to Greg Moody, director of the Governor’s Office of Health Transformation, who said the state has budgeted $60 million in additional Medicaid payments alone in 2018. Commercial insurers will determine their own bonus payments.
“Working together, health care payers, providers, and patient advocates set aside competing interests to agree on system changes that have the greatest potential to maintain and improve health while holding down costs,” Moody said.
Moody credited the new CPC program to the leadership of Gov. John Kasich, who in 2011 charged the Office of Health Care Transformation with bringing together payers, providers and other health care stakeholders to set clear expectations for better health outcomes and improve overall health system performance.
“By working together with our partners in the health care industry, we’ve developed a primary care system that rewards providers who keep costs low, while at the same time help Ohioans lead healthier lives and keep more money in their pockets,” Kasich said in a statement. “Our new effort will better serve those receiving both public and private care, and can serve as a model for other states to follow.”
The Ohio initiative kicks off Jan. 1, 2017 at the same time the federal Centers for Medicare and Medicaid Services will launch a similar program — the Comprehensive Primary Care Plus, or CPC+ — program, authorizing Medicare to pay physicians monthly bonuses for primary-care visits.
Practices selected for the CPC+ program will be invited to join the Ohio CPC program. And after Jan. 1, 2018, any practice that meets the state’s requirements may enroll in the Ohio CPC program.
Combined, the programs aim to improve health outcomes and lower costs for Medicare beneficiaries, consumers enrolled in commercial plans and Medicaid beneficiaries.