New CMS Center for Innovation Reports Show Accomplishments of Multi-Payer Primary Care Transformation

In January, CMS’s Center for Medicare & Medicaid Innovation (the Innovation Center) released two new reports, one evaluating the Multi-Payer Advanced Primary Care Practice (MAPCP) demonstration and the other the Comprehensive Primary Care (CPC) initiative. The reports were the first released by CMS on progress made in the first year of these primary care projects. While both evaluation reports capture only the very early experience of the innovations, they reveal encouraging observations and trends.

In a blog post entitled, “Moving Forward on Primary Care Transformation,” CMS Innovation Center Director Patrick Conway summed up the findings from the reports. He noted that, in its first year, the CPC initiative “decreased hospital admissions by 2% and emergency department visits by 3%, contributing to the reduction of expenditures nearly enough to offset care management fees paid by CMS” and that the “MAPCP demonstration generated an estimated $4.2 million in savings through the use of advanced primary care initiatives.”

The Work of the Multi-State Collaborative

These preliminary findings are good news for the Fund—and its Multi-State Collaborative (MC). Since 2009, the Fund has provided support to state leaders engaged in multi-payer primary care transformation through the MC. Fourteen of the 17 MC member states or market regions participate in either the MAPCP demonstration or CPC initiative.

“Having the forum that became the Multi-State Collaborative empowered the states that were doing this work to come together in a unified way,” says Lisa Dulsky Watkins, Director of the Milbank Memorial Fund Multi-State Collaborative. “Working together this group of states was able to get the attention of leadership at Health and Human Services—and this perhaps encouraged them to set up programs like MAPCP and CPC. The MC basically made the case for Medicare to engage with the states.”

The New Reports

The new reports are rigorous independent evaluations, led respectively by RTI International (with contributions from the Urban Institute and the National Academy for State Health Policy) and Mathematica Policy Research.

“The MC states have been investing time, resources, and energy in these innovations—and they want to understand what the impact of their work has been,” explains Dr. Watkins. “The evaluations, using similar methods for all participants, are powerful tools enabling us to look broadly at the collective impact.”

Moving Forward

Following the release of the new reports, the US Department of Health and Human Services is now committed to shifting Medicare reimbursements from volume to value. In a press release, Health and Human Services Secretary Sylvia M. Burwell made clear her agency’s commitment. She announced “measurable goals and a timeline to move the Medicare program, and the health care system at large, toward paying providers based on the quality, rather than the quantity of care they give patients.” Secretary Burwell specifically cited MAPCP and CPC as mechanisms needed to achieve these goals. In response, the Health Care Transformation Task Force, which includes some of the country’s largest health systems, pledged to put 75% of their businesses in value-based arrangements by 2020.

Read the CMS report about the CPC initiative

Read the CMS report about the MAPCP demonstration