The administration said the up to 20,000 primary care doctors expected to enroll in the program will receive monthly "care management fees" that will give them more freedom to deliver care that is appropriate to their patients, instead of having to rely exclusively on fees for each service they provide an individual patient.
Doctors who see better health outcomes for their groups of patients, as determined by a set of performance data metrics, will keep all or most of those fees, while physicians who fall short will have to repay some of those fees.
The new "Comprehensive Primary Care Plus" model is expected to affect how payments are made for up to 25 million patients who are cared for by 5,000 medical practitioners in 20 regions.
In addition to Medicare, some Medicaid payments and payments by private insurers are expected to be included in the model, according to the federal Centers for Medicare and Medicaid Services.
"The initiative is designed to provide doctors the freedom to care for their patients the way they think will deliver the best outcomes and to pay them for achieving results and improving care," CMS said in a statement announcing the new model, which will operate for at least five years.
The model will join several other CMS "alternative payment model" initiatives, that are part of a broad effort "to move our health care system toward one that rewards clinicians based on the quality, not quantity, of care they give patients," the agency noted. Last month, the Obama administration said that it had beat, by almost a year, its goal of tying 30 percent of Medicare payments to "quality and value through alternative payment models."
The administration is now trying to tie 50 percent of Medicare payments to alternative payment models by 2018.