The U.S. Centers for Medicare & Medicaid Services (CMS) is delaying implementation of the Primary Care First Serious Illness Population payment model and has not announced a new start date. The agency indicated the delay in a note on its Primary Care First website, promising more information in the near future.
The model had previously been delayed from Jan. 1, 2021 to April 1, saying that providers have not had sufficient time to prepare due to the need to focus on the COVID-19 pandemic. CMS has not made any statement as to the reason for the new delay, whether the decision is due to the pandemic or whether it represents a policy change under the new Biden Administration.
“The Primary Care First Model’s Seriously Ill Population component is currently under review, and will not begin on the previously announced April 1, 2021 start date. CMS looks forward to sharing additional information when available,” CMS noted on its website.
CMS announced Primary Care First in April 2019 and planned to implement the models in phases, initially in 26 regions throughout the United States. Hospices and palliative care organizations are eligible to participate in the payment models provided they meet the program’s criteria. The program is designed to control costs, reduce avoidable hospitalizations and improve care coordination.
The Seriously Ill Population payment option, a component of that larger initiative, is designed to serve patients with complex, chronic needs who have received fragmented care.
The Primary Care First direct contracting payment models are also slated to launch April 1, CMS has not given any indication of delays to those program thus far.
The direct contracting options include three voluntary payment models that are designed to help CMS and health care providers reduce the cost of care and improve quality within Medicare fee-for-service programs. The models adapt and integrate concepts from other programs such as Accountable Care Organizations, the Medicare Shared Savings Program, and Medicare Advantage, as well as strategies used in the private sector.