Primary Care First (PCF) and Serious Illness Patient (SIP) Models: Part 2: FFS Payments and Other Claims-Based Adjustment.
The Innovation Center has secured approval for a new Primary Care First (PCF) model with two separate but related components: (1) the PCF component and (2) the Seriously Ill Population (SIP) component. Both components will test alternative payments and the provision of technical support to primary care practices. Practices may participate in one or both components, although individual beneficiaries may only be covered under one component at a time. Primary care practices participating in PCF and/or SIP will receive a combination of claims and non-claims-based payments based on their attributed Medicare fee-for-service (FFS) beneficiaries. With fewer reporting requirements, PCF-only practices will have the flexibility to implement their own strategies that best target outcomes within PCF. SIP-only practices will deliver care to a separate patient population that is both higher risk and shows fragmented patterns of care. This CR is a follow-on to CR 11419.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 20, 2021
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