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AmeriHealth Caritas Louisiana Announces New Comprehensive Primary Care Plus (CPC+) Agreements

Innovative Program Supports Practice Transformation and Puts Focus on Quality, Whole-Person Care

AmeriHealth Caritas Louisiana, a Healthy Louisiana Medicaid managed care health plan and part of the AmeriHealth Caritas Family of Companies, announced it has signed agreements with two Louisiana providers to participate in Comprehensive Primary Care Plus (CPC+), the Centers for Medicare & Medicaid Services’ (CMS) nationwide primary care payment redesign initiative. The agreements with Family Clinic Inc. in Opelousas and Acadiana Family Medical Associates in Rayne come as a next step in AmeriHealth Caritas Louisiana’s implementation of CPC+.

AmeriHealth Caritas Louisiana is one of only four Louisiana health plans (including commercial and Medicare Advantage) selected to participate in the CPC+ program. It allows for aligned funding to support practices in making significant changes in their care delivery. The program rewards providers using incentive payments based on their performance on patient experience, clinical quality, and utilization measures.

By agreeing to participate in CPC+, Family Clinic Inc. and Acadiana Family Medical Associates are making a commitment to go above and beyond in helping to ensure  patients receive the highest level of quality care. Their focus is on five key areas including Access and Continuity, Care Management, Comprehensiveness and Coordination, Patient and Caregiver Engagement, and Planned Care and Population Health. Provider benchmarks include:

  • Ensuring patients have 24/7 access to a care team practitioner with real-time access to the electronic health record (EHR).
  • Developing plans of care and providing targeted, proactive, relationship-based care management to all patients identified as at increased risk.
  • Creating workflows to follow-up with patients following emergency room and inpatient stays.
  • Convening a patient and family advisory council at least once in the first year, and integrating recommendations into care, as appropriate.

AmeriHealth Caritas Louisiana network providers participating in CPC+ have access to a support team that includes care managers, a practice transformation specialist, and dedicated network managers who provide hands-on support to help practices with real-time data insights to better coordinate care for members and help manage their practice’s quality performance.

“Our teams meet face-to-face with providers to understand where they are in their CPC+ implementation and help them establish and reach their goals,” said Lee Reilly, AmeriHealth Caritas Louisiana’s director of practice transformation. “From walking them through the online portal and dashboard, to sharing best practices and helping to develop custom reports and care plans, that collaborative effort and personal touch of supporting the practices is critical to program success.”

“We are committed to improving quality, access, and efficiency in health care for the communities we serve,” said AmeriHealth Caritas Louisiana Market President Kyle Viator. “By giving participating CPC+ practices the freedom to focus on care transformation, we move toward shared goals of improved patient access, continuity of care, reduced cost, and improved health outcomes.”

About AmeriHealth Caritas Louisiana

AmeriHealth Caritas Louisiana is one of five Medicaid managed care plans that participate in the Healthy Louisiana program. AmeriHealth Caritas Louisiana helps Louisiana families get proper care and stay well. AmeriHealth Caritas Louisiana works with communities in need to achieve positive health outcomes throughout the state.

About AmeriHealth Caritas Family of Companies

AmeriHealth Caritas is part of the Independence Health Group in partnership with Blue Cross Blue Shield of Michigan. AmeriHealth Caritas is one of the nation’s leaders in health care solutions for those most in need. Operating in 16 states and the District of Columbia, AmeriHealth Caritas serves approximately 5.6 million Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) members through its integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience serving low-income and chronically ill populations.