CSMS-IPA Agreement With ConnectiCare
A Letter of Agreement (LOA) has been signed with ConnectiCare (CCI) for a pilot program in New London County for their Medicare Advantage (MA) members. This agreement is in coordination with the IPA's™ Patient Centered Practice Model (PCPM). All PCPM physicians who also opt-in with a CCI/IPA opt-in form will have their CCI MA patients become part of the pilot project. The goal is to manage these members'™ medical care in such a way that costs are controlled and quality is improved. It is an excellent opportunity for physician practices in New London County.
This agreement is a surplus-sharing model and has no downside. Your CCI provider agreement, Claims processing and policies remain unchanged.
Primary care physicians will be reimbursed $10 per member-per month for each ConnectiCare patient in addition to Medicare fee for service reimbursement. The IPA is moving forward with a concerted effort to obtain as many opt-ins as possible for a 1/1/10 effective date. To be effective retroactive to 1/1/10, please fax back the opt-in by this Friday, 1/8/10 to (203)225-1295.
This is a separate initiative from the WellCare program. If you signed a WellCare Opt-In, you also need to sign a CCI opt-in to participate in this initiative. Please direct any questions to Edna Wells at
ewells@csms-ipa.com. Happy New Year!
Click
here to get a CCI opt-in form
The Connecticut State Medical Society-IPA (CSMS-IPA) is pleased to offer two exciting new initiatives
The first is with WellCare of Connecticut, Inc. (WellCare). This arrangement is an "upside only" incentive sharing initiative. By opting into WellCare's Medicare Advantage network through the CSMS-IPA, you will be eligible to receive incentive bonus payments in addition to the base fee for service reimbursement of 100% of Medicare. Please click here to obtain a copy of the Opt-In form to participate in this new initiative.
The second new initiative is called the Patient Centered Practice Model (PCPM), which will provide PCPs with a per member per month (PMPM) "management" fee. By opting into the PCPM and participating in CSMS-IPA payer arrangements, you will be eligible to receive a $10 PMPM "management" fee, in addition to existing Medicare fee-for-service reimbursement, provided you comply with the requirements of the PCPM program. This payment will be made to you by CSMS-IPA. Specialists may also benefit by opting in to PCPM with an upside bonus opportunity and inclusion in the patient care-coordination aspect of PCPM. Please choose the appropriate link below whether you are a PCP or a Specialist wishing to opt in to this exciting new healthcare model.
PCP Specialist
Forms can be faxed to the CSMS-IPA at (203) 225-1295. For more information, contact the IPA at (203) 225-1291.
Connecticut Health Plans and Physicians Join Forces to Improve Health Quality
The Connecticut Health Quality Cooperative is a new coalition of Connecticut health care organizations formed to provide physicians with better information to improve the quality of care for patients. Click here for more information.