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Federal Initiative Provides Payment Incentives for Health Centers

Tuesday June 7, 2011
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The U.S. Department of Health and Human Services has announced the Federally Qualified Health Center Advanced Primary Care Practice demonstration project, which will pay an estimated $42 million over three years to up to 500 FQHCs to coordinate care for Medicare patients.

This demonstration project, an Affordable Care Act initiative operated by the Centers for Medicare and Medicaid Services in partnership with the Health Resources Services Administration, will test the effectiveness of healthcare providers — including nurse practitioners and certified nurse-midwives — working in teams to improve care for up to 195,000 Medicare patients.

“FQHCs provide essential primary care services to seniors and others in underserved communities,” CMS Administrator Donald Berwick, MD, said in a news release. “This project will go a long way toward creating comprehensive and coordinated healthcare opportunities for the many people with Medicare who rely on FQHCs as their primary medical providers.”

The FQHC Advanced Primary Care Practice demonstration will show how the patient-centered medical home (PCMH) model can improve quality of care, promote better health and lower costs. Participating FQHCs are expected to achieve Level 3 PCMH recognition, based on meeting established standards of practice; help patients manage chronic conditions; and actively coordinate care for patients.

To help participating FQHCs make these investments in patient care and infrastructure, they will be paid a monthly care management fee for each eligible Medicare beneficiary receiving primary care services. In return, FQHCs agree to adopt care coordination practices that are recognized by the National Committee for Quality Assurance. CMS and HRSA will provide technical assistance to help FQHCs achieve these goals.

“The transformation to a patient-centered medical home is designed to improve the coordination of care for Medicare beneficiaries by helping doctors and other health professionals work in teams,” said Mary Wakefield, RN, PhD, HRSA administrator. “FQHCs in this project can increase access to important primary care services and thus reduce the need for costly hospitalizations or emergency department visits.”

FQHCs that have provided medical services to at least 200 Medicare beneficiaries in the previous 12-month period will be invited by letter to apply to participate in the demonstration. Applications for the project will be accepted from June 6 through Aug. 12, and the demonstration will be conducted Sept. 1 of this year through Aug. 31, 2014.

Details about the demonstration and the application process can be found on the CMS web site at: www.cms.gov/DemoProjectsEvalRpts/MD/ or by visiting the CMS Innovation Center website at http://innovations.cms.gov/

Questions about this CMS demonstration should be directed to fqhc_med_home@cms.hhs.gov.

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