Primary care innovators receive awards totaling $4.8 million from Arkansas Blue Cross

Nov 18, 2022

Arkansas Blue Cross and Blue Shield is financially rewarding primary care clinics participating in three programs that encourage innovation in patient care.

The three programs are:

• Comprehensive Primary Care Plus (CPC+) – an initiative of the federal Center for Medicare & Medicaid Services’ (CMS) Center for Medicare & Medicaid Innovation
• Primary Care First (PCF) – also an initiative of the Center for Medicare & Medicaid Innovation and the successor program to CPC+
• Patient-Centered Medical Homes (PCMH) – a team-based healthcare delivery model that seeks to provide comprehensive and continuous medical care to patients with a goal to obtain maximal health outcomes

The CPC+, PCF and PCMH programs provide financial resources to encourage primary care clinics to test ideas that advance patient care, improve outcomes and reduce low-value care.

For meeting performance goals, 327 participating CPC+, PCF and PCMH clinics, representing 1,537 healthcare providers (caring for 194,388 attributed Arkansas Blue Cross members) will share in more than $4.8 million being awarded by Arkansas Blue Cross. Each clinic met or exceeded its 2021 CPC+, PCF and PCMH clinical quality and utilization measure targets by focusing on:

• Meeting the patient’s needs during a pandemic
• Reducing avoidable hospital admissions and readmissions
• Quality of care
• Total cost of care

“We are encouraged to see that CPC+, PCF and PCMH continue to have such a positive influence on the health of Arkansas Blue Cross members and our state’s healthcare delivery system,” said Alicia Berkemeyer, executive vice president and chief health management officer for Arkansas Blue Cross. “Primary care is the bedrock of our system, and we are happy to see collaborative, provider-led innovation strengthening it throughout our state.”

Launched in 2017, CPC+ was a national advanced primary care medical home model that aimed to strengthen primary care through regionally based multi-payer payment reform. The CPC+ program ended on December 31, 2021.

Primary Care First started in 2021 with a small number of clinics and many CPC+ practices joined the program in 2022, once they completed the CPC+ program. PCF continues to strengthen primary care services and introduces risk and capitation to the payment model.

The Patient-Centered Medical Home program is a model to deliver and organize healthcare that helps to improve the patient’s experience of care, improve the health of populations and reduce or control the costs of healthcare. The PCMH model allows the primary care provider and the patient to be the center of the healthcare system, to know what is going on with their care and help the patient be in control of their health.

In the midst of the pandemic in 2021, members served by providers in these programs had lower rates for emergency department visits, inpatient admissions and hospital readmission rates than people not served by participating providers.

CPC+, PCF and PCMH all emphasize the following comprehensive primary care focuses:

• Access and continuity
• Care management
• Comprehensiveness and coordination
• Patient and caregiver engagement
• Planned care and population health

CPC+, PCF and PCMH provide practices with a robust learning system, as well as actionable data feedback to guide their decision-making. The care delivery redesign ensures practices have the infrastructure to deliver better care, resulting in a healthier patient population.

Arkansas CPC+ clinics receiving 2021awards

Arkansas PCMH clinics receiving 2021 awards

Arkansas PCF clinics receiving 2021 awards