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Evaluation of the Comprehensive Primary Care Initiative

Not Applicable
Completed
Conditions
Medicare Expenditures, Quality of Care
Registration Number
NCT02320591
Lead Sponsor
Mathematica Policy Research, Inc.
Brief Summary

This study assesses the effects of the Centers for Medicare and Medicaid Services' Comprehensive Primary Care (CPC) initiative on physician practices, practice staff, Medicare and Medicaid costs and service utilization, quality of care, and patient outcomes. CPC provides financial resources, timely feedback on key practice outcomes, and a learning network to support practice transformation to improve quality of care and lower costs.

Detailed Description

CMS selected 7 regions (states or substate areas) to include in this study, based on commitment of other (ie, nonMedicare) payers in the area to provide financial resources to participating practices to support practice transformation to improve quality of care, reduce costs, and improve population health. 497 practices were selected from roughly 1000 applicants in the 7 regions to participate in the study. CMS pays participating practices a per member per month care management fee for each Medicare patient attributed to the practice. The practices also receive quarterly feedback on trends in their Medicare patients' use of hospital and emergency room services, Medicare expenditures, and patient outcomes from periodic surveys. Practices are expected to improve patient outcomes and lower Medicare costs per patient by using the additional resources to improve: risk-stratified care management, access and continuity of care, planned chronic and preventive care, patient and caregiver engagement, and coordination across the medical neighborhood. To remain in the study, practices must meet annual milestones for meaningful use of electronic health records and other practice features. The intervention period, which began in Fall 2012, will continue for 4 years.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
365076
Inclusion Criteria
  • Medicare beneficiary attributed to CPC practice or to a matched comparison practice. Patients are attributed to the practice from which they received the most E&M visits during the 2-year period examined.
Exclusion Criteria
  • Beneficiaries enrolled in a managed care plan.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Medicare expenditures12 months

average Medicare expenditures per month in Medicare fee-for-service

Secondary Outcome Measures
NameTimeMethod
30-day hospital readmission rate30-days

whether readmitted to the hospital within 30 days after discharge

number of ER visits12 months

number of emergency room visits that did not result in a hospital admission

number of hospital admissions12 months

number of admissions to general acute short term hospitals during the followup period

hospital admission for ambulatory care sensitive condition12 months

whether admitted to hospital for a condition classified as being sensitive to the quality of ambulatory care received

Trial Locations

Locations (1)

Mathematica Policy Research

🇺🇸

Princeton, New Jersey, United States

Mathematica Policy Research
🇺🇸Princeton, New Jersey, United States

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