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.