What is Ohio CPC?
CPC is a patient-centered medical home program, which is a team-based care delivery model led by a primary care practice that comprehensively manages a patient’s health needs.
The goal is to empower practices to deliver the best care possible to their patients, both improving quality of care and lowering costs. Most medical costs occur outside of a primary care practice, but primary care practitioners can guide many decisions that impact those broader costs, improving cost efficiency and care quality.
CPC entities may be eligible for two payment streams in addition to existing payment arrangements with the Ohio Department of Medicaid and the Medicaid Managed Care Organizations:
- Per-member-per-month (PMPM) payment to support activities required by the CPC program
- Shared savings payment, to reward practices for achieving total cost of care savings
Additionally, joining the CPC program gives entities access to data and reports that provide actionable, timely information needed to make better decisions about outreach, care, and referrals.
What is Ohio CPC for Kids?
Practices enrolled in Ohio’s CPC program that serve Medicaid children under age 21 may also be eligible to participate in CPC for Kids. CPC for Kids is a pediatric-focused component of CPC that provides additional per-member per-month payments and opportunities for quality add-on payments in exchange for performance on additional metrics related to lead testing and immunizations, as well as additional pediatric-focused activities. A brief summary of the CPC for Kids can be found here.