Project Overview

Objective

To determine whether medical practices participating in the Primary Care First alternative payment model improve quality and reduce costs for Medicare fee-for-service beneficiaries.

Project Motivation

The Primary Care First model is a continuation of the Center for Medicare & Medicaid Innovation’s efforts to improve primary care in the United States and to shift from fee-for service to value-based payment.

Partners in Progress

  • Mission Analytics Group
  • Johns Hopkins University

Prepared For

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

Primary Care First is a voluntary, five-year, alternative payment model that rewards value and quality by offering an innovative payment structure to support the delivery of advanced primary care. Mathematica is independently evaluating the model’s implementation, impacts, and implications for future efforts to improve primary care.

Primary care is central to a high-functioning healthcare system. The Primary Care First model provides participating primary care practices with predictable population-based revenue and performance-based payments. The Centers for Medicare & Medicaid Services (CMS) hypothesizes that practices will use these payments to increase patients’ access to advanced primary care services. This, in turn, will lower hospitalization rates, improve quality of care, improve patient experiences of care, and reduce healthcare expenditures.

Read More
/-/media/internet/v2/projects/evaluation-of-the-primary-care-first-model-index.jpg
Project Impact

Findings from the Second Annual Report

  • Practices used model funds to make care delivery changes, including continuing ones they started prior to joining the model, that they believe will ultimately reduce hospitalizations.
  • Primary Care First payments were larger than Medicare fee-for-service payments on average, but many practices felt payments were inadequate.
  • As expected this early in the model, Primary Care First had minimal effects on hospitalizations and Medicare expenditures.
  • Related Staff

    Nancy McCall

    Nancy McCall

    Senior Fellow

    View Bio Page
    Laura Blue

    Laura Blue

    Principal Researcher

    View Bio Page
    Leslie Conwell

    Leslie Conwell

    Principal Researcher

    View Bio Page
    Boyd Gilman

    Boyd Gilman

    Senior Fellow

    View Bio Page
    Karen  Bogen

    Karen Bogen

    Principal Survey Researcher

    View Bio Page
    John Schurrer

    John Schurrer

    Senior Researcher

    View Bio Page
    Lori Timmins

    Lori Timmins

    Principal Researcher

    View Bio Page
    Mario Gruszczynski

    Mario Gruszczynski

    Managing Consultant

    View Bio Page
    Brianna Sullivan

    Brianna Sullivan

    Survey Researcher

    View Bio Page
    Lauren Forrow

    Lauren Forrow

    Senior Statistician

    View Bio Page
    Rachel Machta

    Rachel Machta

    Senior Researcher

    View Bio Page
    Linda Barterian

    Linda Barterian

    Senior Researcher

    View Bio Page

    See Clearly. Act Quickly.

    Our experts can help you make smart, sustainable decisions. From local to global challenges in health, human services, and international development, we’re here to improve public well-being and make progress together.

    Work With Us