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.

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Project Impact

Findings from the First Annual Report

  1. Practices entered the model with advanced primary care capabilities. Their care delivery changes in 2021 were largely enhancements of existing activities.
  2. Estimated Primary Care First payments were generous, averaging about 20 percent higher than practices would have received under the Medicare physician fee schedule.

Related Staff

Nancy McCall

Nancy McCall

Senior Fellow

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Laura Blue

Laura Blue

Principal Researcher

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Leslie Conwell

Leslie Conwell

Principal Researcher

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Rachel Machta

Rachel Machta

Senior Researcher

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Boyd Gilman

Boyd Gilman

Principal Researcher

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Karen  Bogen

Karen Bogen

Principal Survey Researcher

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Linda Barterian

Linda Barterian

Senior Researcher

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