Project Overview
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.
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.
- Mission Analytics Group
- Johns Hopkins University
U.S. Department of Health and Human Services, Center for Medicare & Medicaid Innovation
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.

Findings from the First Annual Report
- Practices entered the model with advanced primary care capabilities. Their care delivery changes in 2021 were largely enhancements of existing activities.
- Estimated Primary Care First payments were generous, averaging about 20 percent higher than practices would have received under the Medicare physician fee schedule.
Evidence & Insights From This Project

Evaluation of the Primary Care First Model: First Annual Report
This report presents findings from Mathematica’s independent evaluation of the first year of the Primary Care First model. The model is a continuation of CMS’ efforts to enhance primary care and move primary care practitioners toward value-based payment.
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