Evaluation of the Comprehensive Primary Care Initiative: Fourth Annual Report

Publisher: Princeton, NJ: Mathematica Policy Research
May 23, 2018
Deborah Peikes, Grace Anglin, Stacy Dale, Erin Fries Taylor, Ann O'Malley, Arkadipta Ghosh, Kaylyn Swankoski, Jesse Crosson, Rosalind Keith, Anne Mutti, Sheila Hoag, Pragya Singh, Ha Tu, Thomas Grannemann, Mariel Finucane, Aparajita Zutshi, Lauren Vollmer, and Randall Brown

Key Findings:

  • CPC practices reported improved primary care delivery, such as care management for high-risk patients, enhanced access, and improved coordination after care transitions.
  • CPC slowed growth in emergency department visits by 2 percent relative to the comparison group. CPC also slowed growth in hospitalizations by 2 percent relative to the comparison group, though this finding was statistically significant only at the 10 percent level.
  • Similar to the earlier two-year results, Medicare expenditures grew more slowly for the CPC group than for the comparison group; however this change in Medicare expenditures was not enough to offset the initiative’s care management fees.
  • CPC did not appreciably improve or worsen physician or beneficiary experience or practice performance on a limited set of Medicare claims-based quality measures.
This is the fourth and final report evaluating the four-year Comprehensive Primary Care (CPC) initiative, which was launched by the Center for Medicare & Medicaid Innovation (CMMI) of the Centers for Medicare & Medicaid Services (CMS) to improve primary care delivery, health care quality, and patient experience, and lower costs. This fourth and final report to CMS covers the full CPC intervention period (October 2012 through December 2016). The report examines: (1) who participated in CPC; (2) the supports practices received; (3) how practices implemented CPC and changed the way they delivered health care; (4) the impacts of CPC on clinicians’ and staff members’ experience; and (5) the impacts of CPC on patient experience, cost, service use, and quality-of-care outcomes for attributed Medicare fee-for-service (FFS) beneficiaries.