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HHS and CMS Announce the Multi-payer Advanced Primary Care Practice Demonstration

U.S. House and Senate Notification
June 2, 2010

The Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) today invited states to apply for participation in the Multi-payer Advanced Primary Care Practice Demonstration, an initiative in which Medicare will join Medicaid and private insurers in state-based efforts to improve the delivery of primary care and lower health care costs.

An Advanced Primary Care (APC) practice, commonly referred to as the patient-centered medical home, is a leading model for efficient management and delivery of quality health care services. APC practices promote accessible, continuous, and coordinated family-centered care utilizing a team approach and emphasizing prevention, health information technology, care coordination and shared decision making among participating patients and their providers.

The demonstration is an opportunity to assess the effect of advanced primary care practice, when supported jointly by Medicare, Medicaid, and private health plans, on:

  • safety, effectiveness, timeliness, and efficiency of health care;
  • assuring access and appropriate utilization of services covered by Medicare, Medicaid, and private health plans, while lowering expenditures;
  • ability of beneficiaries to participate effectively in decisions concerning their care; andelivery of care consistent with evidence-based guidelines.

CMS anticipates making awards to up to six states and will perform an independent evaluation of the projects conducted under this demonstration. To be eligible, states will need to demonstrate that they can meet certain requirements, including having a state agency responsible for implementing the program, being ready to make payments to participating practices six months after being selected for participation, and having mechanisms in place to connect patients to community-based resources.

Information on the demonstration, including the solicitation can be found on the demonstration Web site.

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