Projects

Evaluating the Nation's Largest Primary Care Delivery Model: Comprehensive Primary Care Plus (CPC+)

2016–2023

Project Overview

Objective

We are helping the Centers for Medicare & Medicaid Services (CMS) understand how they can improve the implementation of Comprehensive Primary Care Plus (CPC+). We are also studying the effects of CPC+ on participating practices and on cost, utilization, and patient experience for Medicare fee-for-service beneficiaries.

Project Motivation

Substantial changes to primary care delivery and payment models are hypothesized to improve health care quality and contribute to reductions in health care costs in the United States. Through CPC+, CMS is testing the idea that multipayer payment reform, robust learning supports, actionable data feedback, and health IT vendor support will help primary care practices transform their delivery of care. CMS hypothesizes that this approach will improve access to primary care services and the quality and efficiency of the care that millions of Medicare fee-for-service beneficiaries receive, and ultimately, produce better health outcomes at a lower cost.

Partners in Progress
  • Weill Cornell Medical College
  • Kennell and Associates
  • Digital Dog Direct
  • Data Solutions, Inc.
Prepared For

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

U.S. Department of Health and Human Services, Center for Medicare & Medicaid Innovation

CPC+, a national multipayer primary care improvement model developed by CMS, is the largest and most ambitious primary care and delivery reform ever tested in the United States. Mathematica is independently evaluating CPC+ implementation, impacts, and implications for the future of the model.

Strengthening primary care is thought to be a critical way to promote health and reduce health care costs in the United States. CPC+ is an advanced alternative payment model for primary care that began in 2017 and builds on the foundation of the earlier Comprehensive Primary Care (CPC) initiative, both implemented by the Center for Medicare & Medicaid Innovation in partnership with other private and public payers around the country. This evaluation uses a mixed-methods study to assess whether CPC+ improves quality, reduces expenditures, and results in better health for Medicare beneficiaries in thousands of primary care practices. We are analyzing claims data; surveys and qualitative interviews with patients, primary care practitioners, practice staff, practices, and payers; and data collected for CMS.

CPC+ is a public-private partnership that brings together CMS and 79 private and public payers. Together, the payers provide enhanced financial support for more than 3,000 practices in 18 regions to support fundamental changes in their care delivery toward accessible, comprehensive, team-based care for over 17 million patients. The 79 payer partners committed to align payment, data sharing, and quality metrics with CMS. CPC+ also includes a robust learning system to support practice transformation.

Findings from our evaluation of the second year of CPC+ can be found in the Second Annual Report and are summarized in the two-page Findings at a Glance and a webinar. More detailed information can be found in the Second Annual Report Supplemental Volume and the Appendices to the Supplemental Volume for the Second Annual Report. CMS also summarizes the project in their Perspective.

Our evaluation of the second year of CPC+ builds on our findings from the evaluation’s first year, as well as on our previous work, which includes an evaluation of CPC and research on patient-centered medical homes.

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Project Impact

Selected Findings from This Project

  1. CPC+ provides participating practices with significant payment support.
  2. Practices participating in CPC+ improved behavioral health care for their patients.
  3. CPC+ practices improved their communication with hospitals and emergency departments to better manage patients’ transitions in care.

Related Staff

Deborah  Peikes

Deborah Peikes

Senior Fellow

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Stacy  Dale

Stacy Dale

Senior Researcher

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Ann  O'Malley

Ann O'Malley

Senior Fellow

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Sean Orzol

Sean Orzol

Associate Director

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Dana Petersen

Dana Petersen

Senior Researcher

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Kristin Geonnotti

Kristin Geonnotti

Senior Researcher

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Nancy Duda

Nancy Duda

Senior Survey Researcher

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Arkadipta  Ghosh

Arkadipta Ghosh

Senior Researcher

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Rosalind Keith

Rosalind Keith

Senior Researcher

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Alex Saunders

Alex Saunders

Survey Analyst

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Geraldine Haile

Geraldine Haile

Survey Researcher

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Kaylyn Swankoski

Kaylyn Swankoski

Researcher

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Pragya Singh

Pragya Singh

Researcher

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Jessica Laird

Jessica Laird

Researcher

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