Primary care transformation seeks to reshape health care so that it provides better patient experiences, improves health, and lowers costs, but are such fundamental changes causing physician burnout? In a new article in the Journal of General Internal Medicine, health researchers from Mathematica Policy Research examined how primary care physicians were affected by one of the largest primary care transformation efforts, the Comprehensive Primary Care (CPC) initiative. The Centers for Medicare & Medicaid Services led the initiative alongside 39 private and public payers. The researchers conducted two surveys of primary care physicians working at CPC and matched comparison practice sites, one in the first year of the initiative and one three years later, toward the end of the initiative.
Researchers found that primary care physicians participating in CPC did not report higher or lower rates of burnout, control over work, or job satisfaction compared with other primary care physicians. This is encouraging news for CPC and other similar initiatives, but the survey confirmed that primary care physicians—whether they participate in a transformation initiative or not—are experiencing high levels of burnout and feelings of low control over many aspects of their work. About one-third of physicians in both CPC and comparison practices reported high levels of burnout in the first round of surveys in 2013 and again in 2016. This can pose serious risks to the affected physicians, their patients, and the future of the primary care workforce.
“CPC and other transformation initiatives are asking primary care physicians to undergo some significant changes in how they practice medicine in order to achieve better care for their patients,” said Deborah Peikes, Mathematica senior fellow and project director. “It is encouraging to find that these efforts are not adversely affecting primary care physicians, but it will be important to monitor and test how to address the high proportion of physicians experiencing burnout.”
About the Comprehensive Primary Care (CPC) Initiative
In the Centers for Medicare & Medicaid Services’s CPC initiative, Medicare partnered with 39 commercial and state health insurance plans from October 2012 to December 2016 to provide additional non-visit-based funding, ongoing data feedback on performance, technical assistance, and the opportunity to share in any savings to nearly 500 practices to help them improve care delivery. In return, the participating primary care practices had to achieve milestones specified by the Centers for Medicare & Medicaid Services for each year of the study. Mathematica evaluated the effects of CPC on cost, quality, utilization, and patient and clinician experience, and provided rapid-cycle feedback. Learn more about the CPC evaluation.