Michigan Multipayer CPC+ Monthly Briefing

This bimonthly briefing provides multipayer commercial CPC+ news for Physician Organizations (PO), practices, providers, and other partners.   To be added to the distribution, please send an email with the subject line “Add Me to Michigan Multipayer CPC+ Newsletter Distribution” to MichiganMultipayerCPCPlus@med.umich.edu. Find Past Editions of this Newsletter and other CPC+ Michigan Multipayer updates at www.cpcplusmichigan.org.

September – October 2019

Included in September – October Issue 

Nominations Accepted for CPC+ Michigan Steering Committee Opening – Apply by October 31, 2019

The CPC+ Michigan Multi-Stakeholder Steering Committee is accepting nominations for new members.  Nominees should have leading roles in CPC+ practices or POs and be able to attend bimonthly meetings in Lansing.  Practicing physicians and physician leaders in CPC+ practices are especially encouraged to apply, though nominations are also accepted from clinicians and non-clinicians in operational or administrative roles.  The Nomination Form  includes a link to the Steering Committee charter for additional information.  Nominations will be accepted until October 31, 2019 with decisions communicated by the end of November.

Primary Care First Update

Primary Care First is a model for practices interested in assuming financial risk in exchange for reduced administrative burdens and performance-based outcomes payments.   In response to our request for an update, CMS has shared the following information for those who are interested in the Primary Care First demonstration that is scheduled to begin in 2020.

“We recognize that payers and practices are eager to learn more about the details of Primary Care First (PCF) and to know when the Request for Applications will be available. We look forward to being able to share this information and will use a variety of distribution channels, including this newsletter, to share it widely as soon as it’s available. 

We’ve heard your concerns about the shortened timeline between the application period and the start of the model. We’ll work closely with payers and practices to support their efforts to prepare for model participation and hope the following will help address some of these concerns:

  • Payer partners who are participating in the first year of the model will be given additional time to implement any changes, including payment changes, they may propose in their application.
  • Though the model technically will begin on January 1, 2020, the effective date of proposed CMS payment changes will be April 1, 2020. We recognize that payers may be constrained by established contracting cycles and understand that payers participating in the first year may not be able to fully implement an aligned model by April 1
  • We’ll also allow payers, both current and new, to apply to begin in the second year of the model. Payers who are interested in joining in the second year don’t need to complete an application this summer; there will be a subsequent application period.”
  • CMS encourages those interested in PCF to subscribe to CMS’PCF Model Options listserv and to review the model overview slides and PCF website.

Following is a table that the multipayer support team in Michigan assembled a table that provides a snapshot about what the model means for Michigan practices.  (The table has been pre-reviewed by our CMS partners for accuracy):

Steering Committee Updates and Progress

The CPC+ Multipayer Steering Committee and its four subcommittees have been hard at work supporting CPC+ practice success in Michigan.  A full report-out will be provided at the Payer-Practice Breakout at CMS Learning Session 8 in Grand Rapids.  Slides are attached for those who could not be at the session.  Note the following highlights:

  • The Steering Committee is advocating for an additional year to be added to the CPC+ demonstration for Round One states.  This would (if granted) extend the demonstration until December 31, 2022, the same end date provided for Round Two CPC+ states.  This would allow an additional year for CMS to consider evaluation results and policy implications as well as provide an additional year for practices to demonstrate outcomes-based improvements.
  • The Payer Recruitment Subcommittee has held discussion with a Medicare Advantage plan and several Medicaid Managed Care plans to bode their joining CPC+ for 2020.
  • The Care Interventions Subcommittee has assessed performance of CPC+ practices on ED and Inpatient outcomes and has identified several practices in Michigan with strong performance over time on both measures.  The practices will be queried to arrange call or in-person visits to allow us to learn from their processes and to produce support tools for other CPC+ practices in Michigan.  The Subcommittee’s outreach with national systems leader continues with their most recent explorations of how venture-funded groups are approaching primary care redesign.

Michigan Institute for Care Management and Transformation (MICMT) Upcoming Courses and Educational Offerings

 MICMT Care Management Educational Webinars:

 Topic: SIM Office Hours – Pediatric Depression

 Date/Time:  September 12, 2019 from Noon – 1 pm

 Presenter: Thomas Atkins, MD

 For registration: www.micmrc.org

The SIM Office Hours 9/24/19 topic is “Trauma Informed Care”.  This webinar will offer an introduction to Trauma Informed Care.  Additionally, the webinar will include what does Trauma Informed Care look like and resources to build awareness for a Trauma Informed approach.

Topic:  SIM Office Hours – Trauma Informed Care

Date/Time: September 24, 2019 from 2 to 3 pm

Presenter: Laura E. Gultekin, PhD, FNP-BC, RN, Assistant Professor University of Michigan School of Nursing

For registration: www.micmrc.org

These presentations are supported by Funding Opportunity Number CMS-1G1-14-001 from the U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services. The content provided is solely the responsibility of the authors and does not necessarily represent the official views of HHS or any of its agencies.

SIM Office Hours is open to all.

MICMT Complex Care Management (CCM) Course Registration and MICMT Approved CCM courses:  for course details and registration click here   

MICMT Approved Self-Management Support Programs:  to learn more please visit www.micmrc.org

For questions please contact:   micmt-requests@med.umich.edu

Contact Us! How Can We Help? Supporting CPC+ POs and Practices in Michigan

The joint commercial CPC+ payers in Michigan are working together to support multipayer alignment with the University of Michigan. We advocate with CMS to emphasize the important role that POs play in supporting CPC+ and work with them as partners in the Michigan CPC+ community, work with all participating payers in Michigan to create consistency in payer policy and approach wherever possible, and work to remove roadblocks that practices and POs face in CPC+ implementation and operations. We are interested in your experience of what is going well and what your find challenging. Please contact the CPC+ Michigan Regional Convener, Diane Marriot (dbechel@umich.edu or 734 998 0390) at any time to share your ideas and experiences.