The CMS Innovation Center says the 483 medical practices participating in its Comprehensive Primary Care initiative achieved $24 million in gross Medicare savings, but few saved more than what the government paid them to coordinate patients' care.
The initiative was authorized by the Affordable Care Act and launched in October 2012 to improve primary care by paying clinicians bonuses of about $20 a month per patient for providing care management. The results released Wednesday reflect the work of 483 practices that cared for about 2.7 million patients, including 377,000 enrolled in Medicare.
Providers in four of the program's regions achieved gross savings, the CMS said. The Greater Tulsa, Okla., region, however, was the only area where the savings exceeded what Medicare paid them in care-management fees.
Last year was the first in which participants could earn shared-savings payments, and the Tulsa providers earned about $500,000, the CMS said.
The initiative has produced some encouraging signals that the fees are helping physicians improve care coordination. Readmission rates in all of the program's geographic areas were lower than targeted, and more than 90% of the practices met quality benchmarks for patient experience, the agency said. Patients receiving care from the participating practices scored their primary-care practitioners particularly well on communication and timely access to care.
“Our prior experience with primary-care demonstrations shows that it takes time for primary-care practices to build infrastructure and improve care delivery,” Dr. Patrick Conway, CMS deputy administrator and chief medical officer wrote in a blog post. “These CPC initiative improvements came earlier than expected in a model involving significant changes in the delivery of primary care.”
Participating practices identify at-risk patients and provide care management intended to improve health outcomes. The initiative also enlisted private payers to offer their own enhanced reimbursement for such services.
The CMS selected the seven participating regions in April 2012 based on payer interest and geographic diversity. They include four states—Arkansas, Colorado, New Jersey and Oregon—plus portions of four others: New York's Capital District-Hudson Valley region; Ohio and Kentucky's Cincinnati-Dayton region; and Oklahoma's Greater Tulsa region.