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

Deborah Peikes

Shannon Heitkamp

Katie Lee-Morrison

Eunhae Shin

Ning Fu

Jasmine Little

Mario Gruszczynski

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.

How do you apply evidence?

Take our quick four-question survey to help us curate evidence and insights that serve you.

Take our survey