Primary Care First

Also known as PCF


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About Primary Care First


Primary Care First (PCF) is a voluntary alternative payment model that offers an innovative payment structure to support the delivery of high quality advanced primary care. PCF prioritizes the doctor-patient relationship; enhancing care for patients with complex chronic needs, and focusing financial incentives on improved health outcomes.

Primary Care First aims to improve quality, enhance patient experience of care, and reduce expenditures.

As New Jersey and the rest of the country continue to grow the number of covered lives, the burden of providing these patients with high quality care at a low cost has become the responsibility of the providers, namely the Primary Care Providers, who are often called the “quarterback” of care, and hospitals. Inherent in the Primary Care First Model goals, these clinicians will be generously incentivized to innovate in care delivery workflows and patient care.

What is Primary Care First?



Primary Care First aims to be transparent, simple, and hold practitioners accountable by:

  • Providing model payments to practices through a simple payment structure, including:
    • A flat payment that encourages patient-centered care, and compensates practices for in-person treatment
    • A population-based payment to provide more flexibility in the provision of patient care
    • A performance-based adjustment providing an upside of up to 50% of model payments as well as a small downside (negative 10% of model payments) incentive to reduce costs and improve quality, assessed and paid to practices on a quarterly basis
  • Providing practice participants with performance transparency, through identifiable information on their own practice and other participants' performance to enable and motivate continuous improvement.

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
    • The entire state of New Jersey is one of these 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

Timelines


CMS 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.

HCIS PCF services include:


  • 1 Quality Performance Measure for Optimal Primary/Specialty Alignment Reporting
  • PCF Performance Category Submissions via the CMS Certified Quality Registry
    • Practice Improvement Activities
    • Promoting Interoperability
  • Self Help tools for independent reporting
  • Registry Submission FAQ Access
  • Invitations to SME Performance Year Webinar Series

Consulting services include:


  • Education on PCF reporting category
  • Live support
  • A dedicated PCF advisor
  • Data Optimization for maximized incentive score
  • Reporting Strategies
  • Post Reporting Audit Preparation
  • Performance Data Gap Analysis
  • EHR Vendor Liaison
  • Penalty Avoidance Guidance
  • EHR/PMS Data Report Extraction
  • Secure Remote Support Assistance
  • TCM Patient Care. Management Support (recorded training)

Submission services include:


  • Access to the registry for submission to CMS 
  • PCF Category reporting
  • Self Help tool aids
  • FAQs on registry submission
  • Each submission is reviewed

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HCIS is a CMS Qualified Registry for the Quality Payment Program’s MIPS reporting. This qualification represents HCIS’s 9th consecutive year of being certified by CMS as a Qualified Registry. Essentially serving as a data collector, aggregator, and submitter of value- based care performance data on behalf of Eligible Clinicians Eligible Providers.



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Contact our team if you have any questions or want to be added to our mailing list to receive updates about the PCF program.


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