IT in new risk-based primary care model of CMS: Seven things Must to know

Initially this month CMS declared a new primary care initiative that seeks to assist the practices transition to primary care. Called the Comprehensive Primary Care Plus model, the initiative concentrates on 5 function regions to assist the primary care practices to better communicate with other contributors in the care continuum. CPC+ also places a great emphasis on leveraging health IT to meet these objectives.

Here are the 7 things to know about health information technology in CMS' CPC+ model.

1. The proposed participating practices will be in one of 2 tracks. In both the tracks, practices gain upfront incentive payments that they’ll either keep or repay deployed on performance and quality metrics.


2. Practices in both tracks are needed to utilize the certified health IT to permit remote approach to the EHR, permit 24/7 access to the EHR for the care group members with real-time access, report on electronic clinical quality steps and generate quality reports.


3. Although, there is a greater emphasis in Track Two on leveraging the health IT to acquire healthcare delivery changes. "The care delivery CMS hoped in Track 2 is reliant upon the utilization of advanced health IT abilities that practices will require to attain through EHR enhancements/modifications or by adding or protecting the extra health IT services/tools," in accordance to CMS. "Thus practices will involve their vendors to motivate the attainment and optimization of health IT to meet the targets and goals of practice transformation."


4. The IT needs pertaining particularly to Track 2 involve adopting IT certified to "Care Plan" and "Social, Behavioral and Psychological Data" criteria as recognized in the certified EHR technology definitions in the Medicare EHR Incentive program.


5. Track 2 participants will be hoped to leverage the health IT abilities that aren’t always available in present platforms or aren’t needed for ONC certification. Few of these abilities involve risk-stratifying sufferer populations and recognizing patients with complex requirements; producing and displaying eCQM outcomes at the practice level; assessing patient's psychosocial requirements; developing a patient-focused care plan to instruct the care management; and documenting and detecting patient-reported results.

As such, practices in this track will work with vendors to establish and optimize functions to reinforce clinical targets. "CMS won’t prescribe how the health IT enhancement is accomplished, instead just that the health IT solution meets the CPC target for utilization of the health IT by the CPC practice site team," in accordance to CMS.

6. Moreover, vendors of Track 2 participants will offer a "Letter of Support" to the CPC+ practice showing they’re willing to support the practice in the initiative if the practice is chosen for participation. If the practice is chosen for participation, the vendor will step into a memorandum of understanding with CMS outlining their devotion to support the practices in reaching the targets of the initiative. CMS won’t pay vendors for their participation in CPC+.


7. Entire health IT enhancements are hoped to be completed within 24 months of the January 2017 program beginning.