Michigan Multipayer “QUICK TIPS Sheet”
Reporting Commercial CPC+ 2020 Revenue to CMS
Background
CMS requires CPC+ practices to submit information on revenue received from commercial payers for the 2020 calendar year. This Quick Tips Sheet for Reporting Michigan CPC+ Commercial Revenue was designed to assist in your reporting. In Michigan, as in several other regions, CPC+ practice payments from commercial CPC+ payers (BCBSM and Priority Health) are part of contractual arrangements that existed prior to CPC+.
How Michigan Commercial Payers Will Help POs and Practices
- The elements for you to include for each commercial payer’s revenue revenue received in 2020 (illustrated on page two of this guide) are: 1) the number of attributed CPC+ commercial members and how often payment is issued; 2) the amount of revenue (i.e., including care management G and CPT codes, incentives, Value-Based Reimbursement, etc.) that each practice received from each commercial payer for its CPC+ attributed members; 3) the percent of such payments that were tied to cost or quality performance; and 4) the amount of bonus you received in 2020 for an earlier (e.g., 2019, etc.) year that was related to CPC+ commercial revenue.
- The deadline for practice reporting to CMS is February 26, 2021.
- In advance of this deadline, to ease the burden of reporting on practices, each Michigan participating CPC+ payer partner (BCBSM and Priority Health) will distribute reports to POs for each of their CPC+ practices for distribution to their practices as follows:
- BCBSM distributed the practice-specific reports to POs on January 27, 2021 that detail the revenue disbursed to each CPC+ practice for its attributed CPC+ BCBSM. The reports will use the latest and most complete data available. Thus, reports will cover a twelve-month period from January 2020 to December 2020 that should be reported as 2020 CPC+
revenue to CMS. If you have questions about these payments for your CPC+ members, please contact your PGIP Field Representative. - Priority Health will distribute practice-specific reports to ACNs (POs) that detail the revenue disbursed to each CPC+ practice for its attributed CPC+ Priority membership by February 19, 2020. The reports will use the latest and most complete data available and are anticipated to cover the entire 2020 calendar year period.
- BCBSM distributed the practice-specific reports to POs on January 27, 2021 that detail the revenue disbursed to each CPC+ practice for its attributed CPC+ BCBSM. The reports will use the latest and most complete data available. Thus, reports will cover a twelve-month period from January 2020 to December 2020 that should be reported as 2020 CPC+
This Quick Guide was made possible by our commercial CPC+ plans in Michigan (BCBSM and Priority Health) and was developed in partnership with the CPC+ Michigan Multipayer Initiative Team at the at the University of Michigan, whose mission it is to support effective, efficient multipayer advanced primary care.
