We’ll Help You Get Started
Patient Centered Medial Home (PCMH)
The Patient-Centered Medical Home (PCMH) model is a provider-patient partnership and model of care whereby patient treatment is coordinated through their primary care provider to ensure they receive the necessary care when and where they need it, in a manner they can understand.
Physician Group Incentive Program (PGIP)
Physician Group Incentive Program (PGIP) is a Blue Cross Blue Shield of Michigan incentive program designed to transform care, improve outcomes, and manage health costs through physician organizations across Michigan.
State Innovation Model (SIM)
The State Innovation Models (SIM) initiative partners with states to advance multi-payer health care payment and delivery system reform models. Each state-led model aims to achieve better quality of care, lower costs, and improved health for the population of the participating states or territory. The initiative is testing the ability of state governments to utilize policy and regulatory levers to accelerate health system transformation to meet these aims.
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is legislation that created the Quality Payment Program (QPP). QPP has two options: Merit based Incentive Payment System (MIPS) and the Alternative Payment Methods (APM).
Comprehensive Primary Care Plus (CPC+)
Comprehensive Primary Care Plus (CPC+) is an option of the MACRA/QPP’s Alternative Payment Model. CPC+ is a national advanced primary care medical home model that aims to strengthen primary care through regionally-based multi-payer payment reform and care delivery transformation. CPC+ includes two primary care practice tracks with incrementally advanced care delivery requirements and payment options to meet the diverse needs of primary care practices in the United States (U.S.).
Merit-based Incentive Payment System
The Merit-based Incentive Payment System incorporates aspects of Meaningful Use, PQRS and Value-Based Modifier, probably with some changes. The new design for the program includes Quality, Cost, Advancing Care and Process Improvement measures.
Meaningful Use (MU) is a federal program was designed to support the implementation and robust use of Electronic Health Records by hospitals and ambulatory practice providers. It paid for the “meaningful Use” of EHR to eligible providers/hospitals based on their Medicaid or Medicare patient populations. It is still available to hospitals and Eligible Providers (EP). As of 2017, both modified Stage 2 and Stage 3 are available.
More Meaningful Use resources available here.
Emergency Preparedness Rule
The purpose of the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers is to establish national emergency preparedness requirements to ensure adequate planning for both natural and man-made disasters, and coordination with federal, state, tribal, regional and local emergency preparedness systems.
- Requirements will apply to all 17 providers and supplier types
- Each provider and supplier will have its own set of Emergency Preparedness regulations incorporated into its set of conditions or requirements for certification
- Must be in compliance with Emergency Preparedness regulations to participate in the Medicare or Medicaid program