What you need to know now:
- The Centers for Medicare and Medicaid Services (CMS) Primary Care First (PCF) program is a new alternative payment model designed to support the delivery of advanced primary care. The program began in 2021 and will examine whether financial risk and performance based payments that reward primary care clinicians will lower Medicare costs and improve healthcare quality. Practices selected to participate in the program will begin a 5-year performance period in January 2022.
- As part of the PCF program, CMS requires annual quality measure tracking and reporting. To qualify for a positive performance-based adjustment, practices must meet or exceed average national performance thresholds on a limited set of quality measures that are clinically meaningful for patients. Practice Risk Groups 1 and 2*, are required to track the following measures::
- A patient experience-of-care survey;
- Advance care planning.
- Controlling high blood pressure;
- Diabetes hemoglobin A1c poor control;
- Colorectal cancer screening
- The patient experience-of-care survey must be reported by a PCF approved survey vendor.
- Advance Care Plan must be submitted directly to CMS via claims since it is not an EHR reportable measure.
- The other 3 measures must be submitted via an EHR report that is specifically formatted for the PCF program. This is where MDinteractive can help.
How MDinteractive can help:
If your practice is unable to use your EHR to produce PCF reports for blood pressure control, diabetes hemoglobin poor control, and colorectal cancer screening and your practice is looking for support, MDinteractive can help.
Our team can generate the required QRDA III PCF formatted files if your EHR doesn't support the PCF format. We also can help if you need to combine data from 2 EHRs in order to generate the PCF QRDA III files.
How it Works:
- Your practice uploads QRDA I files with the 3 measures from each clinician on the PCF roster to a secure MDinteractive portal.
- MDinteractive aggregates the data at the Practice Site level and generates the PCF QRDA IIIs as required by the PCF program.
- MDinteractive can give the prepared QRDA III files to the practice for submission through the QPP portal or MDinteractive can submit the files directly to QPP, whichever approach you prefer.
Please also add MDinteractive as your eCQM reporting health IT vendor. Please reference the 2022 PCF Practice Portal Health IT User Guide for detailed instructions on how to update your Health IT Details tab.
Check out this blog for more on this.
The charge for this service is an all-inclusive fee of $199 per clinician.
If you are participating in the program, contact us today to discuss how we can help you meet the annual Quality reporting requirements.
Primary Care First (PCF) Model Evaluation of the First Year (2021)
*Practice Risk Groups 3 and 4 are not required to track the EHR measures.