Alma Family Practice is involved in a number of incentive programs with many different insurance companies. These programs are designed to assist us in providing the best possible care for our patients. They include a variety of requirements such as preventive care services, well visits, and care management.
Alma Family Practice participates in the following programs:
Patient Centered Medical Home (PCMH) --Blue Cross Blue Shield. Practices are challenged to uphold certain quality and safety measures. This includes offering extended office hours, test tracking, referral practices, no cost care management services.
State Innovation Model (SIM) --State of Michigan. Many insurance providers contract with the state of Michigan to provide state funded insurance benefits (Medicaid). SIM focuses on preventive care and social determinants of health. A person with little support from family and friends or low income is at risk of poorer health than others. SIM developed the Community Resources Screening that patients complete with their annual physical paperwork. While it was an idea that focused on Medicaid patients, it only follows that others may have needs that are not known or normally discussed with their health care provider. If patients indicate that they have a need or concern a member of our Care Management team will contact them for further information. The patient or caregiver will be put in touch with community resources that can assist them with their need.
Comprehensive Primary Care Plus (CPC+) ---Centers for Medicare and Medicaid Services (CMS). Many insurance providers contract with CMS to provide insurance benefits to citizens who have Medicare coverage. Not all insurance providers who offer Medicare insurance participate in CPC+. Those that do help ensure that primary care providers encourage and provide complete care. This includes Annual Wellness Visits, preventive services, care compacts with specialists, streamlined electronic referral system, establishing a patient portal through our website and including care management services at no cost to CPC+ members.
PCP Incentive Program (PIP)--Priority Health. Patients who have Priority Health coverage through their employer or Medicare are included in this program. Aspects include similar elements as listed above with our other programs. Priority Health encourages well child checks, preventive services and care management services. Care management is offered at no cost to the Priority Health patient.
Merit-based Incentive Payment System--(MIPS)–Centers for Medicare and Medicaid Services (CMS). Providers who participate with Medicare part B services are eligible for MIPS. This program includes achieving a multitude of quality measures, implementing and maintaining electronic medical records, and improving other areas of service such as patient safety and care coordination.