TY - JOUR KW - Centers for Medicare and Medicaid Services (U.S.)/organization & administration KW - Comprehensive Health Care/organization & administration KW - Databases, Factual KW - Delivery of Health Care/economics KW - Emergency Service, Hospital/economics/statistics & numerical data KW - Female KW - Health Expenditures KW - Humans KW - Male KW - Patient-Centered Care/economics KW - Practice Patterns, Physicians'/economics KW - Primary Health Care/organization & administration KW - Program Evaluation KW - Quality of Health Care KW - Regression Analysis KW - Reimbursement Mechanisms KW - United States KW - Medicare KW - patient experience KW - patient-centered medical home KW - Physician Experience KW - primary care AU - D. Peikes AU - S. Dale AU - A. Ghosh AU - E. F. Taylor AU - K. Swankoski AU - A. S. O'Malley AU - T. J. Day AU - N. Duda AU - P. Singh AU - G. Anglin AU - L. L. Sessums AU - R. S. Brown A1 - AB - The Comprehensive Primary Care Initiative (CPC), a health care delivery model developed by the Centers for Medicare and Medicaid Services (CMS), tested whether multipayer support of 502 primary care practices across the country would improve primary care delivery, improve care quality, or reduce spending. We evaluated the initiative's effects on care delivery and outcomes for fee-for-service Medicare beneficiaries attributed to initiative practices, relative to those attributed to matched comparison practices. CPC practices reported improvements in primary care delivery, including care management for high-risk patients, enhanced access, and improved coordination of care transitions. The initiative slowed growth in emergency department visits by 2 percent in CPC practices, relative to comparison practices. However, it did not reduce Medicare spending enough to cover care management fees or appreciably improve physician or beneficiary experience or practice performance on a limited set of Medicare claims-based quality measures. As CMS and other payers increasingly use alternative payment models that reward quality and value, CPC provides important lessons about supporting practices in transforming care. AD - Deborah Peikes ( dpeikes@mathematica-mpr.com ) is a senior fellow at Mathematica Policy Research in Princeton, New Jersey.; Stacy Dale is a senior researcher at Mathematica Policy Research in Chicago, Illinois.; Arkadipta Ghosh is a senior researcher at Mathematica Policy Research in Princeton.; Erin Fries Taylor is a vice president and managing director of Health Policy Assessment at Mathematica Policy Research in Washington, D.C.; Kaylyn Swankoski is a health analyst at Mathematica Policy Research in Princeton.; Ann S. O'Malley is a senior fellow at Mathematica Policy Research in Washington, D.C.; Timothy J. Day is a health services reseacher in the Research and Rapid-Cycle Evaluation Group, Center for Medicare and Medicaid Innovation, in Baltimore, Maryland.; Nancy Duda is a senior survey researcher at Mathematica Policy Research in Oakland, California.; Pragya Singh is a researcher at Mathematica Policy Research in Princeton.; Grace Anglin is a senior researcher at Mathematica Policy Research in Oakland.; Laura L. Sessums is the director of the Division of Advanced Primary Care in the Seamless Care Models Group, Center for Medicare and Medicaid Innovation, in Baltimore, Maryland.; Randall S. Brown is director of health research at Mathematica Policy Research in Princeton. BT - Health affairs (Project Hope) C5 - Financing & Sustainability; Healthcare Policy CP - 6 CY - United States DO - 10.1377/hlthaff.2017.1678 IS - 6 JF - Health affairs (Project Hope) M1 - Journal Article N2 - The Comprehensive Primary Care Initiative (CPC), a health care delivery model developed by the Centers for Medicare and Medicaid Services (CMS), tested whether multipayer support of 502 primary care practices across the country would improve primary care delivery, improve care quality, or reduce spending. We evaluated the initiative's effects on care delivery and outcomes for fee-for-service Medicare beneficiaries attributed to initiative practices, relative to those attributed to matched comparison practices. CPC practices reported improvements in primary care delivery, including care management for high-risk patients, enhanced access, and improved coordination of care transitions. The initiative slowed growth in emergency department visits by 2 percent in CPC practices, relative to comparison practices. However, it did not reduce Medicare spending enough to cover care management fees or appreciably improve physician or beneficiary experience or practice performance on a limited set of Medicare claims-based quality measures. As CMS and other payers increasingly use alternative payment models that reward quality and value, CPC provides important lessons about supporting practices in transforming care. PP - United States PY - 2018 SN - 1544-5208; 0278-2715 SP - 890 EP - 899 EP - T1 - The Comprehensive Primary Care Initiative: Effects On Spending, Quality, Patients, And Physicians T2 - Health affairs (Project Hope) TI - The Comprehensive Primary Care Initiative: Effects On Spending, Quality, Patients, And Physicians U1 - Financing & Sustainability; Healthcare Policy U2 - 29791190 U3 - 10.1377/hlthaff.2017.1678 VL - 37 VO - 1544-5208; 0278-2715 Y1 - 2018 Y2 - Jun ER -