AmeriHealth Caritas Louisiana, a Healthy Louisiana Medicaid managed care health plan and part of the AmeriHealth Caritas Family of Companies, has been chosen by the Centers for Medicare & Medicaid Services (CMS) to participate in Primary Care First (PCF), the third phase of CMS’ nationwide primary care payment redesign initiative. AmeriHealth Caritas Louisiana is one of only three Louisiana health plans (including Medicaid, Medicare, and commercial) selected to join the state’s Department of Health in this program.
PCF is a multi-payer model designed to provide primary care practices the tools and incentives they need to reduce complications and overutilization of higher cost settings, leading to improved outcomes and reduced spending. As a multi-payer model, PCF also provides an opportunity to collaborate with other payers on best practices around the advancement of value-based care.
As a health care payer, AmeriHealth Caritas Louisiana will implement a model that provides a payment structure designed to support CMS-selected primary care professionals (PCPs) by reducing administrative burden, providing flexibility in the provision of consumer care, and delivering performance-based incentive opportunities based on improved quality and efficiency performance. Participating AmeriHealth Caritas Louisiana network provider organizations will also have access to dashboards that will offer real-time data insights for practices to manage their performance.
AmeriHealth Caritas Louisiana’s participation in the PCF program is the next step of the plan’s ongoing movement toward value-based health care. The health plan currently participates in Comprehensive Primary Care Plus (CPC+), the second phase of CMS’ nationwide primary care payment redesign initiative. It also offers a comprehensive suite of value-based programs for provider organizations across the health care continuum.
This was reported by AmeriHealth Caritas Louisiana on December 3, 2020.
Contact information: AmeriHealth Caritas Louisiana, P.O. Box 83580, Baton Rouge, LA 70884; 888-756-0004; Website: https://www.amerihealthcaritasla.com/contact/index.aspx