Medicare Coverage
Why Glacier Medical Associates Participates in the Advanced Primary Care Management (APCM) Program
At Glacier Medical Associates, our mission is to keep your care local, accessible, and affordable. To do that, we participate in a Medicare program called Advanced Primary Care Management (APCM). We want to share what this program means for you, why it matters, and how it helps us continue caring for our community.
Why APCM Exists
Over the past twenty years, Medicare has steadily reduced payments to independent primary care practices; payments for physician office visits have declined by 25-33% after adjusting for inflation and increasing practice costs. Meanwhile, hospital-owned clinics are paid about twice as much for the same services under the Outpatient Prospective Payment System (OPPS). This imbalance has made it difficult for independent medical groups like ours to continue providing care to Medicare patients. Because of these financial pressures, many independent clinics across the country have stopped accepting Medicare patients altogether, explaining that these programs no longer cover the cost of providing care.
At Glacier Medical Associates, we have chosen a different path—because our core value is caring for our community. We believe our seniors who depend on Medicare deserve access to local, high-quality, independent care.
To make that possible, we participate in the Advanced Primary Care Management (APCM) program. This is not a program we chose, but one chosen for us by Medicare. Participation in the APCM program is the only way Glacier Medical Associates can continue to serve Medicare beneficiaries sustainably.
What APCM Does
APCM changes how we are paid—not how you are cared for.
Instead of paying us only when you have an appointment, Medicare provides a monthly care management payment for each enrolled patient. Before now, Medicare did not pay us for the time we spent between appointments managing referrals and imaging, reading reports from other healthcare providers, talking with you and pharmacies by telephone or email, refilling medications, ordering your medical equipment or other supplies, discussing your care needs with other health care providers and otherwise managing your care in our role as your healthcare partner. The APCM care management payment helps us:
Hire nurse care managers who support you between visits with chronic condition management and care coordination.
Offer same-day appointments to meet patient needs promptly.
Keep our seven-day-a-week urgent care open, billing at primary care rates, which are typically 35% lower than those charged at stand-alone urgent care centers.]
Keep our on-site laboratory open and available to our patients
Remain independent, and physician-owned by your community members.
What It Means for You
Most patients with Medicare Advantage plans do not pay anything out-of-pocket to participate in APCM.
However, some insurance plans assign a small monthly co-pay or coinsurance for this care management service.
Because each insurance plan is different—and we are not insurance experts—we ask that you contact your insurer directly to confirm whether any co-pay applies to your participation in APCM.
Whether your plan covers the cost entirely or includes a modest charge, your participation ensures that we can continue providing the personal, coordinated care you expect from Glacier Medical Associates.
Why Your Participation Matters
To continue caring for Medicare patients, we need all eligible patients to participate in APCM. If you choose not to participate, we fully understand and would be happy to refer you to another healthcare provider outside of Glacier Medical Associates.
Your enrollment directly supports keeping independent, local healthcare available in the Flathead Valley.
Thank you for being part of the Glacier Medical Associates family.
Sincerely,
Glacier Medical Associates
Your Montana Medical Home