Primary Care First Model Evaluation of the Second Performance Year (2022): Findings at a Glance

Primary Care First Model Evaluation of the Second Performance Year (2022): Findings at a Glance

Published: Feb 26, 2024
Publisher: Mathematica
Associated Project

Evaluation of the Primary Care First Model

Time frame: 2019-2028

Prepared for:

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

Mathematica | Progress Together.
Key Findings
  • 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.
  • Prior primary care transformation experience and affiliation with larger health care organizations facilitated these changes.
  • PCF payments were larger than Medicare FFS payments on average, but many practices felt payments were inadequate.
  • Risk group 1 and 2 practices focused on changes to care management strategies and practices in risk groups 3 and 4 took a broader approach to care delivery changes.
  • As expected this early in the model, PCF had minimal effects on hospitalizations and Medicare expenditures.

The Centers for Medicare & Medicaid Services launched the Primary Care First (PCF) Model in 2021 to improve quality of care, improve patients’ experience of care, and reduce expenditures by increasing patients’ access to advanced primary care services through a simplified payment structure designed to reduce administrative burden and reward performance. A second cohort of practices joined in 2022.

This is a summary of Mathematica’s report from the independent evaluation of the second performance year of PCF.

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