Evaluation of the Medicare Care Management Performance Demonstration

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

The Medicare Care Management Performance Demonstration, a congressionally mandated demonstration, offered financial incentives—pay for performance—for small and medium-sized physician (10 or fewer primary care physicians, specialists who offered primary care, and other clinical staff) practices to adopt health information technology, particularly electronic health records. The demonstration operated in four states: Arkansas, California, Massachusetts, and Utah.

Mathematica evaluated whether use of the technology in an integrated program to improve quality of care resulted in better adherence to care standards, improved patient outcomes, and savings to the Medicare program. The evaluation assessed (1) implementation; (2) impacts on quality of care, care coordination, Medicare costs, and beneficiary and physician satisfaction; and (3) associations among quality measures, incentive payments, and health information technology use. The data sources were qualitative data from site visits to practices, one round of a physician survey, two rounds of a beneficiary survey, and Medicare claims data. The final report to Congress is currently under review.