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Advanced Primary Care (APC) Program
NYS and AHI seek to enroll primary care practices that:
- Want to prepare for major payment changes
- Use a 2014 Certified Electronic Health Record (EHR)
- Are not currently participating in a Medicare Shared Savings Program, Pioneer ACO program, Multi-Payer Advanced Primary Care Program, or Comprehensive Primary Care Initiative
What is Advanced Primary Care (APC)?
- An investment of $67 million in federal resources to assist primary care practices to transform to highly-integrated, team-based models relevant to advanced primary care.
- Through a vetted set of milestones and transformation support, practices can achieve an ideal blend of consistency, flexibility, goal-setting, leadership, implementation of workflow changes, and improve outcomes consistent with Value-based Payment (VBP) arrangements.
- The APC milestones are defined as a core set of capabilities acquired over time in the following areas: Patient-Centered Care, Support/Promotion of Population Health, Care Management/Coordination, Access to Care, Advanced use of HIT, Readiness for Alternative Payment Models, and Quality Performance and Improvement.
- Each of the 3 “gates” denotes progress in levels of competencies achieved in each of the milestones.
Why does this matter?
- Medicare, Medicaid, and commercial health insurance providers are changing how they pay health care providers.
- Reimbursement is moving away from fee-for-service to new models that emphasize performance on quality measures, clinical outcomes and cost savings.
- There is also a restructuring underway of the various incentive programs. Performance on quality measures, including clinical outcomes, will determine reimbursement levels.
- Transitioning a practice through the Transforming Clinical Practice Initiative (TCPI) will result in significant benefits as reimbursement becomes more and more quality-based.
Benefits to Practices
- Increase clinician and staff member satisfaction
- Participate in new payment/reimbursement models
- Improve practice efficiency
- Improve clinical efficiency
- Integrate the care management function into your practice
- Concrete opportunities for improvements in patient care
- Maximize the practices’ health information technology investment and use of EHR data
Benefits to the Patient
- Systematic inclusion of patient and family engagement and patient self-management support
- Better coordinated, more comprehensive, and personalized care leading to better outcomes
How will AHI help?
- Coaching and guidance related to transformation
- Skilled transformational assistance provided through a combination of remote and on-site training and support
- Access to a faculty of nationally-recognized experts and online modules (providing CME and MOC credits) related to the transformation process
- Services include, but are not limited to, assistance with maximizing incentives from payer contracts, avoidance of penalties, care management, quality improvement, networking, and more.