New ACA demonstration project will coordinate care for Medicare beneficiaries
A new Affordable Care Act initiative will spend $42 million over three years for a project that will coordinate care for Medicare patients, the Department of Health and Human Services announced Monday.
The demonstration project, operated by the Centers for Medicare & Medicaid Services and the Health Resources Services Administration, will give the funding to 500 Federally Qualified Health Center Advanced Care Practice facilities, known as “medical homes,” to coordinate primary care for up to 195,000 Medicare patients. The program also will enroll dual eligibles, or those individuals who qualify for both Medicare and Medicaid. The project will demonstrate how the medical home model can improve care quality, promote better health and contain costs.
To qualify for this program, FQHC facilities must implement electronic health records, help patients manage chronic conditions and actively coordinate care for these patients. The FQHC facilities will receive a monthly care management fee for each eligible Medicare beneficiary receiving primary care services. In exchange, FQHCs must agree to adopt care coordination practices that are recognized by the National Committee for Quality Assurance, CMS said.
To receive care in these facilities, Medicaid and Medicare beneficiaries cannot be enrolled in Medicare Advantage plans and must have been enrolled in the Medicare Part A and Part B fee-for-service program during the look-back period. They also may not be currently in hospice care or under treatment for end-stage renal disease, according to CMS.