Montana Comprehensive Primary Care Plus (CPC+) Program

August 19, 2016

Written by Patty Kosednar

Montana was selected to be one of only 14 locations across the country to join the Comprehensive Primary Care Plus (CPC+) model. CPC+, the largest-ever initiative of its kind, is a 5-year, multi-payer initiative to invest in high-quality primary care.

Through CPC+, Montana Medicaid, BlueCross BlueShield of Montana, PacificSource Health Plans and Medicare will increase resources for primary care and work to align requirements for providers.

CPC+ is an alternative payment model containing 2 tracks (levels), which offer participating eligible providers an option to avoid MIPS (merit-based incentive payment system) reporting and penalties, as they move though practice transformation and toward pay for performance.  Eligible primary care practices/clinics who are interested in applying to participate in the CPC+ program are encouraged to do so as soon as possible since the program will only accept 5000 practices nationwide, and awards will be made on a first come first served basis.

This is a five-year program and application opportunities will not be made available again until 2021.  Click the application checklist for help in walking you through the application process.

The deadline for primary care practices to apply is September 15, 2016. Practices must submit an application to be considered for the 5-year program. Submission of an application does not bind a practice to participate.

CPC+ Practice Eligibility:

• Must have at least 150 attributed Medicare beneficiaries
• Must have support from CPC+ payer partners (Montana Medicaid, BlueCross BlueShield of Montana, Pacificsource Health Plans)
• Must use certified EHR technology
• Existing care delivery activities must include:
  • Track 1
    • Assigning patients to provider panel
    • Provided 24/7 access for patients
    • Supporting quality improvement activities
  • Track 2
    • All items in Track 1, plus –
    • Developing and recording care plans
    • Following up with patients after ED or hospital discharge
    • Implementing a process to link patients to community based resources
• Track 2 Must apply with a letter of support from Health IT vendor

Please email me if you have any questions, comments or would like additional information.

For more complete information on the CPC+ program, please check out the following links:

• MT DPHHS CPC+ Page
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• CMS CPC+ Page
• CMS PCP+ FAQs
• CMS List of CPC+ Webinars
• CPC+ Application Portal

Please let me know if you have any comments or questions.

Leave a reply, ask a question or share information using the “Leave a Reply” section below, or email Patty Kosednar directly with your questions or comments.

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