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Posted: 11:31 a.m. Friday, Aug. 24, 2012

Area physicians selected for pilot program

By Chelsey Levingston

Staff Writer

This week, 75 physician practices were selected to participate in the region’s pilot program to pay primary care doctors more for providing higher quality, better coordinated care.

The Cincinnati-Dayton-Springfield region was picked in April by the Centers for Medicare & Medicaid Services to be one of seven regions in the U.S. to participate in this Comprehensive Primary Care Initiative. A first-of-its-kind study, the program is a public-private partnership of CMS, area doctor practices, managed care plans and commercial insurance payers.

Among those selected was Family Practice Associates, a four-doctor practice in Middletown. It was a competitive application process.

Participating physicians were required to invest extensive funding into health care information technology, according to Family Practice.

“We are very excited to have been selected as one of only 500 practices in the United States to set new landmarks aimed towards providing exceptional patient care,” said Dr. Thomas Furlong, founder of Family Practice, in a release.

CMS will pay primary care practices a care management fee, initially an average of $20 per beneficiary per month. At the same time, commercial, state, and other federal insurance plans will also offer enhanced payment to primary care practices that provide high-quality primary care on behalf of their members, CMS said.

For patients, this means these physicians may offer longer and more flexible hours, use electronic health records, coordinate care with patients’ other health care providers, better engage patients and caregivers in managing their own care, and provide individualized, enhanced care for patients living with multiple chronic diseases and higher needs, all according to CMS.

The four-year initiative goes live Nov. 1, according to insurer Aetna.

“We’re now paying more based on quality of service than we are quantity,” said Michelle Mathieu, vice president of network services for Aetna in Ohio and Kentucky. “What we’re certainly hoping is year-over-year we can show better efficiency. Did we actually lower the overall cost?”

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