Independent Evaluation of the Comprehensive Primary Care Plus (CPC+): Fourth Annual Report

Independent Evaluation of the Comprehensive Primary Care Plus (CPC+): Fourth Annual Report

Published: May 17, 2022
Publisher: Mathematica
Associated Project

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

Time frame: 2016–2023

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


Kaylyn Swankoski

Ann O'Malley

Ha Tu

Kristin Geonnotti

Deborah Peikes

Amanda Markovitz

Shannon Heitkamp

Katie Lee-Morrison

Eunhae Shin

Ning Fu

Jasmine Little

Tim Lake

Kristie Liao

Melanie Au

Margaret Coit

Jan Genevro

Stefanie Pietras

Laura Hanson

Lianlian Lei

Eric Dehus

Randall Brown

Key Findings
  • Practices’ ability to work on CPC+ care delivery requirements was hindered by the COVID-19 pandemic, but a range of supports (such as care managers) and temporary changes in payment policies (such as Medicare fee-for-service payment for telehealth) helped practices continue to fund their COVID-19 work.
  • CPC+ practices cited care management fees as the most useful type of CPC+ payment support they received, used primarily to fund the salaries of care managers, behavioral health care providers, and other staff to improve care delivery.
  • The annual increase in the number of practice sites with on-site behavioral health specialists was valuable, particularly during the fourth year as the COVID-19 pandemic increased mental health care demand during a very challenging time to secure services.
  • CPC+ practices saw reductions in emergency department (ED) visits, acute hospitalizations, and acute hospitalization expenditures and improvement in some quality-of-care measures, though overall savings to Medicare were offset by increases in expenditures on other services.

The Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Fourth Annual Report covers the first four years of CPC+ for the 2,905 practices in regions that began CPC+ in 2017. The report examines (1) engagement in CPC+ by payer partners and health IT vendors and participation by practices; (2) the supports practices received; (3) how practices implemented CPC+ and changed the way they delivered health care; and (4) the impacts of CPC+ on cost, service use, limited claims-based quality-of-care outcomes, and patient experience for attributed Medicare fee-for-service beneficiaries four years into the five year model. An overview of findings from the fourth annual report is available in the two page Findings at a Glance.

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