Evaluating the Nation's Largest Primary Care Delivery Initiative

2016-2019
Prepared for
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services

Strengthening primary care is critical to promoting health and reducing costs in the United States. Comprehensive Primary Care Plus, or CPC+, is an advanced alternative payment model for primary care that builds on the foundation of the Comprehensive Primary Care initiative, implemented by the Center for Medicare & Medicaid Innovation from 2012 through 2016. The evaluation is assessing whether CPC+ achieves better health, improved care, and smarter spending for Medicare and Medicaid beneficiaries in thousands of primary care practices using a mixed methods study. We are analyzing claims data; survey and qualitative interviews with patients, clinicians, practice staff, practices, and payers; and program data.

CPC+ is a public-private partnership that brings together CMS, commercial insurance plans, Medicaid managed care plans, and state Medicaid agencies to provide the financial support necessary for nearly 3,000 practices in 14 regions to make fundamental changes in their care delivery. CMS is working with 54 payer partners with a shared commitment to align on payment, data sharing, and quality metrics throughout the five-year initiative.

Mathematica is examining whether the model has the potential to lower Medicare and Medicaid expenditures while maintaining or improving the quality of beneficiaries’ care. CPC+ includes a robust learning system to facilitate advancements in quality measurement, performance feedback to practices, and the use of promising health information technology.

This study builds on our related work, including an evaluation of CPC and research on patient centered medical homes.