ACO Primary Care Flex Model Overview Factsheet

Beginning January 1, 2025, the CMS Innovation Center will test a new payment model for primary care, the ACO Primary Care Flex Model, within the Medicare Shared Savings Program. This video provides information about that model.
Visit the Shared Savings Program’s Application Types & Timelines webpage below for more information.
www.cms.gov/medicare/payment/...
#Medicare #ACO #PrimaryCare #PaymentModel #ACOPrimaryCareFlexModel #SharedSavingsProgram
Disclaimer: The information presented in this video is for the general education and knowledge of our viewers and does not constitute legal advice regarding any specific situation.
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[@celinela9637]

What is going to be the actual dollar amounts of the PPCP payments? Is it going to be $20 - 60 or $60 - 120 or $120 - $600, much like the MAPD counterparts?

[@QualityConsultant169]

Hi Celine, Thank you for your query. The PPCP is made up of two parts, a County Base Rate to cover PPCP-eligible services (Prospective Primary Care Payment County Base Rate) and an Enhanced Amount for providing enhanced primary care services (Prospective Primary Care Payment Enhanced Amount).
The amount of payment made by CMS to the ACO will depend on the County Base Rate, which is derived from the average primary care spending in its county, and the Enhanced Amount(s) based on characteristics of the ACO and its assigned patient population. For most model participants, CMS expects that the PPCP will increase primary care funding relative to ACOs’ historical expenditures. (Retrieved from CMS ACO Primary Care Flex Model FAQs) Hope this helps.