Evaluation of the Comprehensive Primary Care Initiative

2012-2017
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

A large body of research shows that patients do not receive well-coordinated care, leading to duplicative or ineffective treatment, excessive costs, and poor patient outcomes. Because patients typically see their primary care physician first when symptoms arise and rely on this physician to make any necessary referrals, the federal government is focusing on initiatives to improve the quality and comprehensiveness of primary care. 

The Comprehensive Primary Care (CPC) initiative is one of the largest efforts by the Centers for Medicare & Medicaid Services (CMS) to strengthen primary care. Medicare partners with commercial and state health insurance plans in seven markets nationwide to provide additional non-visit based funding, ongoing data feedback on performance, technical assistance, and shared savings to nearly 500 practices to facilitate their transformation into a higher functioning entity. The participating primary care practices, selected from nearly 1,000 applicants, must achieve milestones specified by CMS for each year of the study, with the expectation that meeting them will improve care delivery and result in better care for the individual; better health outcomes for populations; and lower costs.

Mathematica and its partner, Group Health Research Institute, are evaluating the effects of CPC on cost, quality, utilization, and patient and provider experience. In addition, we are providing rapid-cycle (quarterly) feedback to participating practices, CMS, and CMS’s regional partners on these measures, enabling them to see trends in performance over time and how their programs compare to those of their peers.