Primary Care First Application Process Now Open for 2022 Start Date

Timelines

The practice solicitation period for PCF Cohort 2 opened on March 16, 2021 and will close on April 30, 2021. The payer solicitation period for PCF Cohort 2 began on March 16, 2021, and will close on May 28, 2021.

Practice and payer selections will take place in Summer or Fall 2021. Cohort 2 will begin participation in PCF in January 2022. CMS plans to focus on onboarding participating practices and payer partners to the model from July–December 2021.

Cohort 2 Eligibility Requirements

Eligible Primary Care First Cohort 2 applicants are primary care practices that:

• Are located in one of the 26 Primary Care First regions.
• Include primary care practitioners (MD, DO, CNS, NP, and PA) certified in internal medicine, general medicine, geriatric medicine, family medicine, and hospice and palliative medicine.
• Provide primary care health services to a minimum of 125 attributed Medicare beneficiaries at a particular location.
• Have primary care services account for at least 50% of the practice’s collective billing based on revenue. In the case of a multi-specialty practice, 50% of the practice’s eligible primary care practitioners’ combined revenue must come from primary care services.
• Have experience with value-based payment arrangements or payments based on cost, quality, and/or utilization performance such as shared savings, performance-based incentive payments, and episode-based payments, and/or alternative to fee-for-service payments such as full or partial capitation.
• Adopt and maintain, at a minimum, health IT meeting the definition of CEHRT at 42 CFR 414.1305 and the certification criteria found at 45 CFR 170.315(c)(1)-(3) for electronic clinical quality measure (eCQM) reporting, using the most recent update available on January 1 of the Measurement Period, for the eCQMs in the Primary Care First measure set; support data exchange with other providers and health systems via Application Programming Interface (API); and connect to their regional health information exchange (HIE).
• Attest via questions in the Practice Application to a limited set of advanced primary care delivery capabilities, such as 24/7 access to a practitioner or nurse call line and empanelment of patients to a practitioner or care team.
• Are able to meet the requirements of the Primary Care First Participation Agreement.

Kris Gates, [email protected], 402.321.6188