Evaluation of the Comprehensive Primary Care Initiative: First Annual Report

Publisher: Princeton, NJ: Mathematica Policy Research
Jan 30, 2015
Erin Fries Taylor, Stacy Dale, Deborah Peikes, Randall Brown, Arkadipta Ghosh, Jesse Crosson, Grace Anglin, Rosalind Keith, and Rachel Shapiro

Key Findings: 

  • Results from this first year suggest that CPC has generated nearly enough savings in Medicare health care expenditures to offset care management fees paid by CMS.
  • The primary sources of the savings were reduced rates of hospital admissions and emergency department visits.
  • The bulk of the savings was generated by patients in the highest-risk quartile, but favorable results were also seen in other patients.
  • More than 90 percent of practices successfully met all first-year transformation requirements.  

In October 2012, the Center for Medicare & Medicaid Innovation of the Centers for Medicare & Medicaid Services (CMS), in a unique collaboration between public and private health care payers, launched the Comprehensive Primary Care (CPC) initiative to improve primary care delivery in seven regions across the United States. CPC requires that practices meet annual milestones that help them build the capability to deliver CPC’s five functions: (1) access and continuity, (2) planned chronic and preventive care, (3) risk-stratified care management, (4) patient and caregiver engagement, and (5) coordination of care across the medical neighborhood. To help participating practices achieve these functions, CPC offers three main supports: enhanced payment, data feedback, and learning activities and technical assistance. The substantial transformation involved in executing these functions is expected to achieve better health care, better health outcomes, and lower costs. This first annual report to CMS describes the implementation and impacts of CPC over its first year.