Assessing the Effects of Primary Care Transformation: Emerging Themes and Practical Strategies to Strengthen the Evidence

There is ample international evidence that a high-quality, low-cost, and socially inclusive health care system must be built on a strong foundation of primary care services. Nonetheless, as a country, we spend a smaller proportion of our health care dollars on primary care than any other developed country. To act on this evidence, we must learn what constitutes high-quality primary care and how to increase its adoption.

The 18 projects involved in the Milbank Memorial Fund’s Multi-State Collaborative (MC) are engaged in multi-payer primary care transformation—and learning how to do it better. Assessing their own projects and acting on those findings have been important components of the MC programs.

Many MC members have been conducting formal evaluations of their effectiveness. To help them learn how to do their evaluations better and improve the effectiveness of their projects, the Fund engaged Mathematica Policy Research to develop this report and “evaluate the evaluations.” The report analyzes eight of the MC member evaluations.

The findings assess the strength of the evidence in the evaluations and will help improve future assessments in the critical work of making primary care better.