These measures were selected to be actionable, clinically meaningful, and aligned with CMS’s broader quality measurement strategy. A PCF practice must meet standards that reflect quality care in order to be eligible for a positive performance-based adjustment to their primary care model payments. In Primary Care First, CMS uses a focused set of clinical quality and patient experience measures to assess quality of care delivered at the practice. Primary Care First aims to foster practitioner independence by increasing flexibility for primary care, providing participating practitioners with the freedom to innovate their care delivery approach based on their unique patient population and resources. PCF participants may receive additional revenue based on their performance on easily understood, actionable outcomes. The Centers for Medicare & Medicaid Services (CMS) will prioritize patient choice in the assignment of Medicare beneficiaries to Primary Care First practices. ![]() Primary Care First prioritizes patients by emphasizing the clinician-patient relationship. Primary Care First focuses on advanced primary care practices ready to assume financial risk and receive performance-based payments. The model tests whether delivery of advanced primary care can reduce total cost of care, accommodating practices at multiple stages of readiness to assume accountability for patient outcomes. Primary Care First addresses these needs through seamless coordinated care and accommodates a continuum of interested practices and clinicians. Primary care is central to a high-functioning healthcare system and thus, there is an urgent need to preserve and strengthen primary care as well as a need for support of serious illness care services for Medicare beneficiaries. ![]() Strengthening the primary care doctor–patient relationship and enabling patients to receive more care from their primary care doctor can help improve the quality of patient care and reduce avoidable hospitalizations.For example, practices may offer around-the-clock access to a clinician and support for health-related social needs. The Primary Care First model is designed to help primary care practices better support their patients in managing their health - especially patients with complex, chronic health conditions - and enables primary care doctors to offer a broader range of health care services that meet the needs of their patients.These patients may see their health issues worsen, causing them to seek higher cost care, such as hospitalization, trips to the emergency room, or greater need to use specialty care. Patients who do not regularly see a primary care doctor are significantly less likely to get regular health screenings, monitoring for emerging health issues, and other preventive health care.There are approximately 2,600 practices participating in Primary Care First across both cohorts, and 19 payer partners. To view an interactive map of this Model, visit the Where Innovation is Happening page, and select this model from the drop-down menu on the left side of the page. Primary Care First includes two cohorts of participating practices: Cohort 1 began in January 2021 and Cohort 2 began in January 2022. Primary Care First is offered in 26 regions: Alaska (statewide), Arkansas (statewide), California (statewide), Colorado (statewide), Delaware (statewide), Florida (statewide), Greater Buffalo region (New York), Greater Kansas City region (Kansas and Missouri), Greater Philadelphia region (Pennsylvania), Hawaii (statewide), Louisiana (statewide), Maine (statewide), Massachusetts (statewide), Michigan (statewide), Montana (statewide), Nebraska (statewide), New Hampshire (statewide), New Jersey (statewide), North Dakota (statewide), North Hudson-Capital region (New York), Ohio and Northern Kentucky region (statewide in Ohio and partial state in Kentucky), Oklahoma (statewide), Oregon (statewide), Rhode Island (statewide), Tennessee (statewide), and Virginia (statewide). In response to input from primary care clinician stakeholders, Primary Care First is based on the principles underlying the existing Comprehensive Primary Care Plus (CPC+) model design: prioritizing the clinician-patient relationship enhancing care for patients with complex chronic needs, and focusing financial incentives on improved health outcomes. Primary Care First is a voluntary alternative five-year payment model that rewards value and quality by offering an innovative payment structure to support the delivery of advanced primary care.
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