Primary care makes strides in improving quality and costs

Today, the Centers for Medicare & Medicaid Services (CMS) announced promising results of the first shared savings performance year for the Comprehensive Primary Care (CPC) initiative. This model is part of our broader effort at CMS to promote better care, smarter spending, and healthier people.

In 2014, CPC practices showed positive quality results, with hospital readmissions lower than national benchmarks and high performance on patient experience measures, particularly on provider communication with patients and timely access to care. CPC practices that demonstrated high quality care and reduced spending above a threshold shared in savings generated for Medicare.

During this first shared savings performance year, the initiative decreased Medicare Part A and Part B spending compared to spending targets while achieving high quality outcomes. The CPC initiative generated a total of $24 million in gross savings overall (excluding the CPC care management fees). These results reflect the work of 483 practices that served approximately 377,000 people with Medicare and more than 2.7 million patients overall. Four of the CPC initiative’s seven regions (Arkansas, Colorado, Cincinnati-Dayton region of Ohio, and Oregon) generated gross savings. The Greater Tulsa region decreased costs in excess of the CPC care management fees, generating net savings of $10.8 million and earning more than $500,000 in shared savings payments.

Quality highlights from the first shared savings performance year include:

• Over 90 percent of CPC practices successfully met quality targets on patient experience (as determined by the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys) and utilization (hospital admission and readmission) measures, indicating quality scores that matched or exceeded national comparisons.
• All regions had lower-than-targeted hospital readmission rates. Readmissions can be burdensome to patients and caregivers and costly to the healthcare system. Lower readmissions indicate better coordination of care during transitions and patient support during the post-discharge period.
• Patients receiving care from CPC practices scored their primary care practitioners highly, particularly on how well clinicians communicate and on getting timely access to care.

The CPC initiative launched in October 2012 to advance primary care by paying clinicians to deliver accessible, comprehensive, and coordinated care. Advanced primary care is the foundation of a high-performing health system. In addition to attending to patients’ acute, chronic, and preventive health care needs, primary care practices act as the quarterback of the health care team. CPC practices help patients navigate their care, communicate with specialists and hospitals, and ensure that patients with complex social and medical needs do not “fall through the cracks” of the health care system.