Fifty-nine primary care practices representing 254 physicians are currently participating in a four-year pilot program by the Centers for Medicare & Medicaid Services known as CPCI, the Comprehensive Primary Care Initiative.
It is one of several experiments conducted or sanctioned by the federal government to find ways to make the delivery of health care services more efficient and cost-effective. And while CPCI’s earliest results were mixed, costs actually rose slightly in Arkansas, the most rural of the pilot regions and the poorest based on dual Medicare/Medicaid eligibility. Arkansas also has the largest concentration of disabled patients.
The CPCI was launched at the beginning of the federal government’s fiscal year in October 2012, and it is set to expire in September 2016. Participating practices in Arkansas received payments from CMS in addition to the usual payments from Medicare, the median being $211,000 ($77,000 per physician), according to the first report CMS issued in January 2015.
With those expenses included, according to the report, average monthly Medicare expenditures increased by $22 (3 percent) among all patients in Arkansas, and the average monthly Medicare expenditure on hospice services increased by $4 (23 percent).
Overall, savings in direct patient care did not quite cover the fees paid to the participating physicians.
Physician groups participating in CPCI are not eligible to participate in savings-sharing initiatives like Accountable Care Organizations, but they will be if the CPCI program expires on schedule next year.
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