Family Medicine for America's Health

Comprehensive Primary Care Payment Calculator

Comprehensive Primary Care Payment Calculator

The Comprehensive Primary Care Payment Calculator project team, led by Stanley Borg, D.O. developed a tool designed to create specific examples for both practices and payers to better understand how a Comprehensive Primary Care Payment may be implemented. Physicians and payers can now explore new options for developing PCMH payment frameworks and/or replace existing capitation and FFS contracts.

The CPCP Calculator is a work in progress, meant as a starting point for discussion with your practice and with payers and employers. It is one example of how health plans and physicians might deploy a CPCP payment. We encourage and expect that stakeholders will modify the proposed methodology for specific markets and contractual relationships.

In order to build a working CPCP model, the team researched current primary care reimbursement models. Then a document detailing the CPCP methodology approach was created. The team invites you to use the Calculator and welcomes your feedback.

See the Calculator and User Guide.

See the Background Research Report and Methodology.

Legal Disclaimer:Information provided in connection with this calculator by FMAHealth and its contributors is not a suggestion, invitation, direction or recommendation with respect to what you should charge or what your reimbursement rates should be for your services. Those determinations must be made by each physician or practice based on your own costs, patient population, regional and/or practice-specific circumstances, business judgment, negotiations with payers, and other factors within your discretion. This information is intended to increase the quality and availability of care and services for patients and to enhance, not suppress, competition for such services.

Tactic Team

The payment calculator was developed by the FMAHealth Payment Team. Contact us at strategy@fmahealth.org

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