Choosing Your Hybrid Payment Selection for 2018

September 1, 2017

Written by Kristen Schuster, Practice Facilitator

It is hard to believe we are already approaching Quarter 3 on the CPC+ timeline. With that comes a decision for Track 2 practices. As a Track 2 participant you selected a hybrid payment ratio. This payment methodology will allow the practice flexibility to deliver care in an appropriate setting and not be tied to the limitations of fee-for-service (FFS) billing.

For example:

Telehealth visits
Home health visits
Group visits

This hybrid payment ratio will change from year-to-year at the discretion of the CPC+ practice. The goal by 2021 is to have payments be either 40% paid upfront and 60% FFS or 65% paid upfront and 35% FFS. The changes made to FFS payments can be made in steps to reach the 2021 goals and payment year 2018 is the next step. The options below will be available to your practice for payments in 2018.

25% upfront CPCP and 75% of FFS E&M
40% upfront CPCP and 60% of FFS E&M
65% upfront CPCP and 35% of FFS E&M

The selection will be made during the Q3 care delivery reporting that will be done in the CMS Practice Portal between September 25th and October 13th. Now is the time to discuss this next step in payment transformation with your administration and decision-making staff. DO NOT WAIT!

Don’t forget the next Montana In-Person Learning Session is scheduled for September 13 at 8:30 a.m. in Bozeman at the Comfort Inn. Please register here. The Montana Practice Facilitators team, CMS and Lewin look forward to see you all there.

Also, please refer to the Payment Methodology available on CPC+ Connect. On the Plus Side is a weekly newsletter, emailed to all subscribers that lists upcoming educational events, CPC+ tasks and links to CMS resources. Please reference this along with this blog for upcoming CMS deadlines. As always, complete CPC+ information from CMS can be found on the CPC+ Connect Portal. We encourage you to access the portal and check out all available CMS CPC+ resources.

If you have any questions, or run into issues with any of the CPC+ objectives and would like help please use the “Leave a Reply” section below, or email Kristen Schuster directly with your questions or comments.

Other Resource Links
Catch up on the national learning webinars with Mountain-Pacific Quality Health’s quick FAQ sheet.

Recorded CMS Feedback Report Webinar
CMS Change Package
See all CPC+ Blog Posts

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