CMS primary Cares is a brand new approach for primary care which rewards doctors for providing excellent services to the patients that lets them stay out of the hospitals and avoid expensive treatments. It basically provides 5 new payments for providers, letting them take changing levels of responsibility for improving care and costs. It is extremely beneficial for patients with chronic problems like Diabetes who are largely dependent on costly treatment in hospitals.
This new plan is going to target Primary care which is an arena that incurs 3% of the costs initially but later on deals with diseases which accounts for a good % of one’s expenses.
The participation of the providers in the program is voluntary which means officials will be required to convince a decent number of primary care providers. The initiative will also encourage physicians using technology in best possible way and monitoring patients in remote areas to ace the game. Providers are given extra flexibility to work on innovative ways for patients with savings benefit if they keep patients healthier.
The need of reform took birth from the fact that in the next 8 years, medical services expenses will grow by 5.5%. It is estimated that by 2027, it will be around $6 trillion. It is 19.4% of the national income. The payment service introduced on Monday told about 2 pathways called “Direct Contracting” and “Primary Care First” and in this initiative.
“Primary Care first” will deal with small practices and cover a monthly payment per-patient for providers. Providers are granted good payment if their patient remains healthy but would lose some amount as well, if they get sicker.
Direct Contracting is for bigger provider organizations which includes 3 payment options. One option lets provider to receive a total monthly payment for the costs while other gives option to the provider to manage the risk of it.