Greater Buffalo Region selected for Innovative Primary Care Initiative

Greater Buffalo Region selected for Innovative Primary Care Initiative

Western New York one of only 4 regions in the country to participate in The Centers for Medicare and Medicaid Services’ Comprehensive Primary Care Plus Initiative

BUFFALO, NY, MAY 22, 2017 – The Centers for Medicare and Medicaid Services (CMS) announced the selection of the Greater Buffalo region to participate in CMS’ Comprehensive Primary Care Plus (CPC+) Initiative, an advanced medical home model aimed at strengthening primary care to support improved care, better population health, and lower health costs.

The collaborative efforts of Independent Health and BlueCross BlueShield of Western New York helped to secure this initiative and continue the transformation of Western New York into a high-performing health care community

The first round of CPC+ began in January, 2017 with 14 regions. The Greater Buffalo region is one of 4 regions selected for the second phase of CPC+, which will begin in January, 2018:

1. Greater Buffalo Region (Erie and Niagara Counties)
2. Louisiana: Statewide
3. Nebraska: Statewide
4. North Dakota: Statewide

CMS selected the regions based on the maturity of primary care practices that have transitioned to a patient-centered medical home model and the prevalence of multi-payer value-based payment methodologies. The goal of the five-year initiative is to help primary care practices in Erie and Niagara Counties transform the way they deliver care in order to:

  • Support patients with serious or chronic diseases achieve their health goals;
  • Give patients 24-hour access to care and health information;
  • Deliver preventive care;
  • Engage patients and their families in their own care;
  • Work together with hospitals and other clinicians, including specialists, to provide better-coordinated care.

Independent Health and BlueCross BlueShield of Western New York were selected to participate based on membership density and alignment with CMS’ approach to payment, data sharing, and quality measurement.

“Western New York has a history of collaboration in efforts to improve the health of our community,” said Michael W. Cropp, M.D., president and chief executive officer, Independent Health. “Organizations such as Western New York HEALTHeLINK and the P2 Collaborative are examples of how we’ve used the power of collaboration to improve care delivery in Western New York. We look forward to working with the primary care community, CMS, and BlueCross BlueShield of Western New York on this innovative initiative.”

“The selection of Greater Buffalo for the CPC+ program is great news for our region as it will bring additional funds and support to local primary care providers,” said David Anderson, President and CEO, BlueCross BlueShield of Western New York. “This initiative coincides with BlueCross BlueShield’s focus on advancing primary care through our BestPractice program. We’re proud of CMS’ recognition of BestPractice and look forward to further supporting primary care providers alongside CMS and Independent Health.”

BlueCross BlueShield’s BestPractice initiative launched in 2017 as the region’s largest reimbursement program focused on reinforcing the importance of primary care. Closely aligned with CPC+, the program provides a combination of regular monthly payments and fee-for-service payments that encourage overall health and prevention - giving primary care doctors freedom to determine how they provide services to their patients. More than 1,000 primary care providers and nearly 400,000 BlueCross BlueShield members are benefiting from this model which rewards quality and efficient health care.

Independent Health’s long history of partnerships with primary care physicians include a patient-centered medical home model that grew into The Primary Connection, an alliance established by Independent Health and forward-thinking primary care physicians in 2012. Composed of a group of nearly 200 primary care physicians from 35 practices treating approximately 121,000 Independent Health members, The Primary Connection is committed to improving the patient’s care experience, transforming their relationships with specialists to achieve closer coordination of care, and accomplishing better outcomes, all of which will lead to lower costs.

“Independent Health has long believed the vitality of the primary care physician is critical to transforming the way health care is delivered,” said Thomas J. Foels, M.D., Independent Health’s Executive Vice President and Chief Medical Officer. “We’re thrilled to be able to use our experience with The Primary Connection practices and other provider partners to revitalize and grow primary care.”

“The value of primary care hasn’t always been recognized through traditional fee-for-service models,” said Thomas Schenk, BlueCross BlueShield’s Senior Vice President and Chief Medical Officer. “Initiatives like BestPractice and CPC+ will support the additional costs of practice transformation, reinforce workflows necessary to improve quality and downstream costs and reward primary care doctors for the important and significant work they do to improve their patient’s health – even outside the typical office visit.”

The CPC+ payment model includes two separate tracks. Each track gives practices the additional financial resources and flexibility to make investments toward improving quality of care and reducing the number of unnecessary services their patients receive. CPC+ provides practices with performance data on cost and utilization to help their decision making.

The initiative will be open to any primary care provider in Erie or Niagara counties with more than 125 patients covered by Original Medicare.