An experiment to comprehensively redesign advanced primary care is showing signs of progress, the CMS said Monday in announcing the results of the second performance year of its Comprehensive Primary Care initiative.
Of the 481 participating practices, 95% met quality of care requirements and four of seven regions shared in savings, according to the CMS. In 2015, the program generated $57.7 million in gross savings across Medicare Parts A and B -- slightly less than the $58 million the CMS paid out in care management fees. These gross savings nearly doubled from the first shared savings performance year, in 2014.
“CPC demonstrates the potential of primary care clinicians redesigning their practices to deliver better care to their patients,” Dr. Patrick Conway, principal deputy administrator and chief medical officer for the CMS, wrote in a blog post. “Primary care transformation takes time,” he added, calling the combination of savings and undiminished quality of care “encouraging.”
The Comprehensive Primary Care initiative launched in October 2012 under the CMS' Innovation Center. The four-year, multi-payer project encompassed seven regions: the states of Arkansas, Colorado, New Jersey and Oregon, plus the Hudson Valley region of New York state, the Cincinnati-Dayton region of Ohio and Kentucky, and Greater Tulsa, in Oklahoma.
Providers that participated had the chance to share in savings by receiving population-based care management fees for providing five primary care functions. Those five functions -- risk-stratified care management, access and continuity, preventative care and planned care for chronic conditions, patient and caregiver engagement, and care coordination across different medical facilities—were aimed at improving care and lowering costs.
Four regions—Arkansas, Colorado and Oregon, and Greater Tulsa—accrued net savings. The other three did not, but according to the CMS, the savings from the other four regions compensated for those losses.
In addition to generating overall savings, practices in the CPC program showed improvement in certain measures of healthcare quality, the CMS said. Their hospital admission and readmission rates were lower than expected, and 99% of practices exceeded national levels of colorectal cancer screening and immunizations for influenza.
Patients rated care from CPC practitioners “highly, particularly on how well practitioners supported them in taking care of their own health and the attention they paid to care from other providers,” the CMS said.
Also noteworthy was the use of electronic Clinical Quality Measures during the 2015 performance year, which constituted first year that the CMS included performance on these measures when it determined savings under the CPC initiative. These data are recorded in electronic health records during care, offering practices real-time feedback and constituting a tool the CMS considers critical to transforming care delivery and driving population health.
